ECRR
Chernobyl: 20 Years On
Health Effects of the Chernobyl Accident
European Committee on Radiation Risk
Documents of the ECRR 2006 No1
Eds: C.C.Busby and A.V Yablokov
ECRR
Chernobyl: 20 Years On
Health Effects of the Chernobyl Accident
European Committee on Radiation Risk
Documents of the ECRR 2006 No1
Edited by
C.C.Busby and A.V.Yablokov
Published on behalf of the European Committee
on Radiation Risk
Comité Européen sur le Risque de l’Irradiation
Green Audit
2006
European Committee on Radiation Risk
Comité Européen sur le Risque de l’Irradiation
Secretariat: Greta Bengtsson, Grattan Healy
Scientific Secretary: Chris Busby
Website: www.euradcom.org
Contact: [email protected]
ECRR
Chernobyl 20 Years On; The Health Effects of the Chernobyl Accident
Documents of the ECRR 2006 No 1
Edited by:
Chris Busby, Alexey Yablokov
Published for the ECRR by:
Green Audit Press, Aberystwyth, SY23 1DZ, United Kingdom
Copies of this book can be ordered directly from
[email protected] or from any bookseller
Copyright 2006: The European Committee on Radiation Risk
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First Edition: April 2006
ISBN: 1-897761-25-2
A catalogue for this book is available from the British Library
Printed in Wales by Cambrian Printers
(Cover: Boy with Thyroid Cancer in Belarus- Photo: Andrew Testa)
What do we really know today? Really not too much… Chernobyl produced 31
deaths and 2,000 avoidable thyroid cancers in children. No other
internationally confirmed evidence exists.
Abel Gonzalez.
Representative of the International Atomic Energy Agency (IAEA)
Speaking at WHO conference on Chernobyl Effects in Kiev, Ukraine, 2001.
The risk of leukaemia doesn’t appear to be elevated even among the recovery
workers. No scientific evidence either for increases in cancer incidence or
other non-malignant disorders that could be related to the accident exists.
Norman Gentner.
Representative of the United Nations Scientific Committee on the Effects of
Atomic Radiation (UNSCEAR). Speaking at WHO conference on Chernobyl
Effects in Kiev, Ukraine, 2001.
.
The consequences of Chernobyl do not fade away but actually grow
increasingly uncertain and in many ways more intense. I agree with the UN
Secretary General Kofi Annan, who said,’the legacy of Chernobyl will be with
us and our descendants for generations to come’.
D.Zupka
Representative of the United Nations Office for Humanitarian Affairs
(OCHA). Speaking at WHO conference on Chernobyl Effects in Kiev,
Ukraine, 2001.
They were deliberating among themselves as to how they could give
Wings to Death so that it could, in a moment, penetrate everywhere,
both near and far.
Jan Amos Komensky (Comenius)
The Labyrinth of the Worlds (1623)
‘Run like a dog and flee like a hare’
This volume is dedicated to the Chernobyl ‘liquidators’.
They gave their lives so that Europe could remain inhabitable.
They were poorly repaid.
Contents
Introduction
1. Alexey V. Yablokov.
The Chernobyl Catastrophe - 20 Years After
2. E.B. Burlakova and A.G Nazarov
Is it Safe to Live in Territories Contaminated with Radioactivity?
Consequences of the Chernobyl Accident 20 Years Later
3. Konstantin N. Loganovsky
Mental, Psychological and Central Nervous System Effects of the
Chernobyl Accident Exposures
4. Eugene Yu. Krysanov,
The Influence of the Chernobyl Accident on Wild Vertebrate
Animals.
5. G.P.Snigiryova and V.A.Shevchenko
Chromosome Aberrations in the Blood Lymphocytes of People
Exposed as a Result of the Chernobyl Accident
6. Inge Schmitz-Feuerhake
Teratogenic Effects After Chernobyl
7. D.M.Grodzinsky
Reflections of the Chernobyl Catastrophe on the Plant World:
Special and General Biological Aspects
8. Chris Busby
Infant Leukaemia in Europe After Chernobyl and its Significance
for Radioprotection; a Meta-Analysis of Three Countries Including
New Data from the UK.
9. 1 Alexey .V. Yablokov.
The Health of the Chernobyl Liquidators- a Meta-analysis
10 Tetsuji Imanaka
Did Acute Radiation Syndrome Occur Among the Inhabitants of the
30 km Zone?
11 Helmut Küchenhoff, Astrid Engelhardt, Alfred Körblein
Combined Spatial-temporal Analysis of Malformation Rates in
Bavaria After the Chernobyl Accident
12. V.B. Nesterenko and A.V. Nesterenko
Radioecological Effects in Belarus 20 Years After the Chernobyl
Catastrophe: The Need for Long-term Radiation Protection of the
Population
13. Alfred Koerblein
Studies of Pregnancy Outcome Following the Chernobyl Accident
14. Rosalie Bertell
The Death Toll of the Chernobyl Accident.
1
5
49
61
89
95
105
117
135
143
169
179
185
227
245
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Introduction
One of the first sub-committees formed by the European Committee on Radiation
Risk (ECRR) was the Chernobyl sub-Committee. Its remit was to examine the
epidemiological and other evidence on the health effects of low dose radiation
exposure which could be obtained from careful study of populations living in areas
contaminated by the Chernobyl accident. The ECRR had been founded on the basis
that many scientists had criticised the external acute exposure foundations of the
current radiation risk model (employed by all countries for radiation protection
purposes), the model, essentially, of the International Commission on Radiological
Protection (ICRP). This model, it was argued, was scientifically invalid for internal
chronic irradiation from fission product isotopes and radioactive microscopic
particles.
It seemed to the committee that the Chernobyl catastrophe represented a
unique opportunity or natural laboratory to examine the health effects of such lowdose internal exposures. Knowledge obtained from such studies would be valuable
in developing an accurate understanding of the effects of radiation, and also in
interpreting the many reports of apparent associations between cancer, leukaemia
or other ill health and prior exposures to internal radionuclides e.g. from weapons
test fallout, and nuclear site discharges. Indeed, the question of the adequacy of the
ICRP external risk model had been called into question for many years by a
number of independent scientists and, with the rapid developments of radiation
biology in the 1990s following the discovery of ‘genomic instability’, by the early
2000s calls were increasingly being made to re-examine the issue. In 2001,
following much anecdotal evidence of increases in ill health in the Chernobyl
affected territories of the ex-Soviet Union, and also reports of increases in infant
leukaemia in European countries in the children who were in the womb over the
period of the internal exposures, the European Parliament called for the reexamination of these models specifically in connection with the effects of the
Chernobyl accident.
Also in 2001, in the UK, a new committee was set up under the joint
direction of the Department of the Environment and the Department of Health. The
remit of this Committee Examining Radiation Risk from Internal Emitters
(CERRIE) was to examine just these issues. In 2003 CERRIE organised an
international workshop in Oxford and most of the major radiation risk experts in
the world were invited to attend to discuss the issues and comment on the draft
reports. Most did so. Among those who came were the eminent scientists
Professors Alexey Yablokov, Elena Burlakova and Inge Schmitz Feuerhake. The
Russian scientists drew attention to the many studies reported in the Russian
language literature. These research papers on the Chernobyl effects were not being
translated into English by the UN agencies, nor by the World Health Organisation
(WHO). For this reason (they said) the terrible effects of low dose radiation in the
Chernobyl affected territories were being ignored or glossed over. Surely CERRIE
should attempt to examine the truly enormous amount of useful information that
these Russian language reports represented? In the event, the CERRIE secretariat
1
ECRR 2006: CHERNOBYL 20 YEARS AFTER
did nothing and the CERRIE committee ended in 2004 split on the issue of internal
radiation with two reports being published in late 2004. Only the Minority
CERRIE report reviewed some fifty of the main Russian studies and drew attention
to the serious cancer and non-cancer effects following Chernobyl reported in the
Russian journals.
It is now the 20th anniversary of the accident and in the West nothing has
changed. It as if none of these events ever occurred. Children continue to die of
cancer near nuclear polluted sites, which still continue to release fission-product
radioisotopes under licenses based on the IRCP model. Court cases are still lost by
the enraged and desperate parents because judges still believe that the doses to the
children were too low. Scientists on government committees still talk about
‘absorbed dose’ as if it were a meaningful concept for internal irradiation. The
Emperor still wears his new clothes.
The evidence from the Chernobyl affected territories, presented here in
these chapters, reveals the real-world consequences of a simple and terrible new
discovery: that the effects of low dose internal irradiation cause subtle changes in
the genome that result in an increase in the general mutation rate. This genomic
instability was first seen in cells in the laboratory. The Chernobyl evidence,
presented here, shows that this seems to be true for all species, for plants and
animals and humans. It has profound implications that go beyond radiation
protection and risk models. In the review paper by Krysanov in this collection we
find that mice living in the high irradiation zone, 22 generations after the initial
exposure, are more radiosensitive than mice living in lower exposure areas. The
same effect is reported for plants by Grodzhinsky who wryly points out that plants
cannot exhibit the ‘radiophobia’ that many of the Chernobyl effects have been
blamed on. This flies in the face of current ideas about genetic selection.
The effects of genomic instability are apparent in the evidence of massive
harm to the organs and systems of living creatures at low doses of internal
exposure, resulting in a kind of radiation ageing associated with random mutations
in all cells. At the higher doses in the ‘liquidators’, after some years, their bodies
seem to simply fall apart. In an astonishing statement we hear from Yablokov that
in Moscow 100% of the liquidators are sick, in Leningrad 85%. These are men that
ran like hares into the radiation fields with improvised lead waistcoats cut from
roofs and who, by stabilising the situation at the reactor, saved Europe from a
nuclear explosion equivalent to 50 Hiroshima Bombs - an outcome that would have
made most of it uninhabitable. They are forgotten.
Whole biological systems collapse; at the cell level, at the tissue level and
at the population level. Burlakova and Nazarov describe these subtle effects at
lower doses of internal irradiation in laboratory cell systems and also people,
Grodzhinsky shows the effects in plants, - higher for internal exposures than
external, Krysanov shows the effects in wild animals and Yablokov and the
Nesterenkos in the children and adults living and continuing to live in the
contaminated territories. The effects clearly operate at what are presently thought
to be vanishingly low doses. The increases in infant leukaemia in several countries
in Europe flag up the extreme dissonance between the IRCP model and the true
effects. This finding has been ignored by the WHO. The papers are not referenced
2
ECRR 2006: CHERNOBYL 20 YEARS AFTER
in UNSCEAR or in the recent US BEIR VII report. The comparison between the
expected and observed cases of infant leukaemia gives a clear indication of an error
of upwards of 150-fold in the current model’s prediction. This is shocking. It
means that the previous releases to the environment from accidents, from weapons
tests or under licence have killed and will still kill millions. The effects of the
1960s atmospheric weapons tests are with us and our children forever and are
clearly responsible for many of the current illnesses.
It is a scandal that UN agencies charged with protecting the public - e.g.
the United Nations Scientific Committee on the Effects of Atomic Radiation
(UNSCEAR) or the World Health Organisation (WHO) - can ignore the huge
amount of evidence from the Chernobyl accident that shows these effects. This
evidence has been presented to them again and again. Yet in the WHO conference
on Chernobyl in Kiev in 2001 the representative of UNSCEAR, Norman Gentner
stated clearly:
The risk of leukaemia doesn’t appear to be elevated even among the recovery
workers. No scientific evidence for increases in cancer incidence or other nonmalignant disorders that could be related to the accident.
Science moves forward through experiment and through observation. The
radiation risk model presently used to underpin legal constraints on public
exposure is based mainly on the theory that the external acute radiation effects in
the Japanese A-Bomb survivors can be used to predict and explain effects from
exposure to internal novel fission-products that never existed on earth for the whole
of evolution. The Chernobyl accident and its appalling outcomes have given the
human race the empirical evidence to test this theory. The observations made or
reviewed in these extraordinary chapters - many written by eminent scientistsmakes it fundamentally clear that the present radiation risk model is flawed.
The ECRR sub-committee on Chernobyl has worked hard under difficult
conditions to assemble the contributions from these eminent scientists and to put
them into reasonable English. This book represents a landmark on the road to
understanding the effects of low-dose chronic irradiation. The committee believe
that these lessons should be borne in mind by policy makers who are, even now,
discussing new investments in nuclear energy and ways in which historic and
future radionuclide waste can be disposed of into the environment. The committee
recommends this book to scientists and policymakers and concerned members of
the public in the hope that the huge amount of work carried out by scientists
publishing their results in Russian language journals and others studying the effects
of the Chernobyl accident will influence their decisions in this important area of
public health.
The Committee thanks Greta Bengtsson, Mireille de Messieres and Saoirse
Morgan for their hard work in the preparation of this book.
Chris Busby, Scientific Secretary, ECRR
3
ECRR 2006: CHERNOBYL 20 YEARS AFTER
4
ECRR 2006: CHERNOBYL 20 YEARS AFTER
CHAPTER 1
The Chernobyl Catastrophe - 20 Years After (a meta-review)
Alexey V. Yablokov
Russian Academy of Sciences, and Center for Russian Ecological Policy, Moscow
The first official forecasts regarding the consequences of the explosion of the reactor in
the 4th block of the Chernobyl NPP on April 26th, 1986 concerning the health of the
population of the USSR predicted only several additional cases of cancer over some tens of
years. In 20 years it has become clear that not tens, hundreds or thousands, but millions of
people in the Northern hemisphere have suffered and will suffer from the Chernobyl
catastrophe. These people include (Grodzinsky, 1999 et al):
1. More than 220,000 residents of highly contaminated areas who were evacuated in
1987 across Belarus, Russia and Ukraine.
2. Those who received significant doses of irradiation during the first days and
weeks, and/or living in territories with radioactive pollution more than 1 Ci/km2
(in Ukraine - up to 3,2 millions, in Russia - up to 2,4 million, in Belarus - up to
2,6 million persons, in Sweden, Norway, Bulgaria. Romania, Austria, Southern
Germany and a number of other countries across Europe - 0,5 - 0,8 million
persons).
3. Liquidators (the persons who took part in operations to minimize the
consequences of the catastrophe both at the NPP and in the polluted territories
nearby): 740 thousand persons from Ukraine, Russia and Belarus, and 80 - 90
thousand from Moldova, the Baltic’s states, the Caucasus, Middle and Central
Asia;
4. Children, whose parents belong to the first three groups: Up to 2,006 approx. 1 - 2
million.
5. People living in territories where the Chernobyl fallout fell, basically, in the
Northern hemisphere (including Europe, North America, Asia): A number
difficult to define, but not less than 2,500 million persons;
6. People who have consumed the Chernobyl fallouts’ radioactive-polluted
foodstuffs (basically, in the countries of the former USSR, but also in Sweden,
Norway, Scotland and a number of other European countries) – possibly in the
order of several hundred thousands.
For the first of these four groups exposed to the consequence of the Chernobyl disaster
additional irradiation is (or can be) substantially determined, for the fifth and sixth groups stochastic.
Official secrecy (until May 23rd, 1989) and irreversible state falsification of
medical data during first three years after the catastrophe, as well as an absence of authentic
medical statistics in the former USSR, highlights the inadequacy of material concerning
primary epidemiological consequences of this catastrophe. There is also uncertainty in
determining the quantity of radionuclides discharged from the reactor: from 50 million Ci
(Soviet official data) up to 3,500 millions Ci (several independent estimations).
There are some principal difficulties in establishing a direct connection between levels
of irradiation and health effects. These difficulties include:
• extremely localized concentrations of fallout:
• difficulty establishing the dose of radiation exposure caused by short-lived
radionuclides during the first hours, days and weeks after catastrophe (I-133, I135, Te-132 and a number of others);
5
ECRR 2006: CHERNOBYL 20 YEARS AFTER
•
•
the behaviour of "hot particles»;
too complex a picture of the radionuclides’ transformations, migration and bioconcentrations in ecosystems;
• little known specific effect of each radionuclide (e.g. pollution by Sr-90 has
consequences for the immune system, pollution by Cs-137 - others under identical
density of radiation, Evetz et al., 1993);
• different biological effects of internal and external irradiation (e.g. internal
irradiation leads to a gradual auto-immune reaction, whereas external irradiation
leads to a fast one. Lisianyi, Lubich, 2001).
The problems listed above make it difficult to reconstruct individual doses and dose rates,
and cast doubt on any reports of a “strong correlation” between levels of the Chernobyl
irradiation and specific health effects.
Further difficulties in understanding the real consequences of the Chernobyl
radioactive fallout include numerous, scientifically unproven statements made by
representatives of the nuclear industry, and experts connected with it, about the
insignificance of the catastrophe for public health (e.g., “Chernobyl Forum Report”,
September 2005).
In order to reveal the full consequences of the Chernobyl catastrophe it is essential
to discover its true influence on public health by comparing the same groups during the
same periods after the catastrophe and comparing populations in territories, identical in
geographical, social and economic conditions and differing only by the level of irradiation.
1. Mortality
Since 1986, in the USSR, life expectancy has noticeably decreased. On average, infant
mortality has noticeably increased, as well as death rates for those of advanced ages. There
is no proof of a direct connection between these parameters and the Chernobyl catastrophe,
but there is proof of such connections for particular polluted territories.
After 1986, in the radioactively polluted areas of Ukraine, Belarus and Russia,
there is an increase in general mortality by comparison with neighboring areas (Grodzinsky,
1999; Omelianetz, et al., 2001; Kashirina, 2005; Sergeeva et al., 2005).
An increase in the number of stillbirths, correlating with the level of pollution, is
noted for of some areas of Ukraine (Kulakov et al., 1993) and Belarus (Golovko, Izhevsky,
1996). The number of spontaneous abortions (miscarriages) has noticeably increased in
some polluted territories of Russia. By some estimates, the number of miscarriages and
stillbirths as a result of radioactive pollution in Ukraine has reached 50,000 (Lipik, 2004).
In some European countries an increase in perinatal mortality connected with the
Chernobyl catastrophe has been revealed (see Korblein paper in this book). After 1987 an
increase in infant and children's mortality is noted in the polluted areas of Ukraine
(Omelianetz, Klement’eva, 2001) and Russia (Utka et al., 2005). Presented in Table 1 is
one example of such mortality in one Russian area.
6
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 1 Infant (per 1,000 live births) and general mortality (per 1,000) in three
radioactively polluted administrative districts of Bryansk area, Russia in 1995 - 1998 (the
Condition …, 1999; Komogortseva, 2001).
Three polluted districts*
1995
1996
1997
Infant mortality 17.2
17.6
17.7
General
16.7
17.0
18.2
mortality
*Novozybkovsky, Klintsovsky, Zlynkovsky.
1998
20.0
21,4
Bryansk
area
Russia
1998
10,2
16.3
1997
17.2
13.8
Cancer mortality for 1986 - 1998 has increased by 18 - 22 % in radioactively polluted
Ukrainian territories and among the evacuees, (compared with the whole of Ukraine - 12
%) (Omelianetz et al., 2001; Golubchikov et al., 2002). Mortality in men from prostate
cancer has increased in the Ukrainian polluted territories by 1,5 - 2,2 times (in Ukraine as a
whole - by 1,3 times) (Оmelianetz et al., 2001). It has been revealed that in the
radioactively polluted territories of Belarus the majority of sudden deaths correlated with
the level of radionuclide incorporation (Bandajevsky, 1999).
These facts that establish a general increase in the level of child and infant
mortality in the radioactively polluted territories (and to a greater degree on the more
polluted territories) when compared with similar data in uncontaminated territories, leave
no doubt that absence of these data for the whole area of the Chernobyl fallout region has
hitherto been associated with incorrect statistical data.
2. Cancers
Belarus showed a 40 % increase in cancer between 1990 and 2000. Thus, in the territories
most radioactively polluted (the Gomel area) the increase was maximal, and in the least
polluted (the Brest and Mogyliov areas) - minimal (Okeanov et al., 2004). In 1987 - 1999 in
Belarus about 26,000 radiogenic cancers (including leucosis) were noted; from these cases
11,000 have died (Mal’kov, 2001). Average value of excess absolute cancer risk was
434/104 person/years/Sv (relative risk - 3 - 13 x 10-1), which is above the limit accepted by
UNSCEAR (Mal’kov, 2001).
Table 2 presents calculations of cancer rates based on a collective dose of all
generations for the entire period of additional Chernobyl Cs-137 irradiation.
For the general number of people in different countries who will have cancers
from the Chernobyl Cs-137 during their lifetime (about 951,000 persons, see Table 2), it is
necessary to add the number of cancer cases as a result of irradiation by I-133, I-135
(mostly thyroid cancers) and more than 25 other short-lived nuclides, including strontium,
plutonium and americium, uranium and hot particles.
7
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 2 Calculated number of cancer cases (without leukaemia) for all generations *,
caused by Chernobyl Cs-137 (Goffmann, 1994)
Number of cases
Fatal
Non- fatal
CIS, European part
212 150
212 150
The Europe (without the CIS)
244 786
244 786
Other countries of the world
18 512
18 512
IN TOTAL
475 368
475 368
* On the basis of an expected collective dose "indefinitely" in 127.4 million person/Rad.
Although other estimates of the number of fatal cancer cases induced by the Chernobyl
irradiation claim "only" 22,000 – 28,000 deaths, J. Goffmann (1994) convincingly reveals a
clear understatement on behalf of the authors, or the unreasonable understating of the
collective dose, based on underestimates of emissions from the blown up reactor. Table 3
presents some examples of the research that has shown connections between occurrence of
some cancers and the Chernobyl pollution.
Before the Chernobyl catastrophe cancer of the thyroid gland in children and
teenagers in territories in Ukraine, Belarus and Russia rarely occurred. In Belarus only 21
cases were registered between 1965-1985 (Demedchik et al., 1994), in Ukraine, before the
catastrophe, no more than 5 cases were registered annually, in nearby Russia - 100. In the
year 2000 the number of cases of this cancer in children and teenagers in the polluted
territories had increased by hundreds of times. 4,400 cases of radiation-induced thyroid
cancer have been recorded in Belarus (Malko, 2002) and about 12,000 cases of thyroid
cancer are considered to have already appeared in the affected three countries (Imanaka,
2002). This differs from the UNSCEAR 2000 estimation of about 1,800 thyroid cancers
observed during 1990 - 1998 in children 0 - 17 years old in 1986, and differs from the
Chernobyl Forum Report’s (2005) estimation of about 4,000 cases.
In Belarus the relative risk of radio-induced thyroid cancer (ERR) has exceeded
more than the risk factor of 8x 10-2 Gy-1 from ICRP-60 (Malko, 2004).
Based on the dynamics of radiogenic thyroid cancer growth and the character of
the pollution, it is possible to assume that during the following 40 - 50 years in Ukraine
there will be about 30,000 additional cancer cases, in Belarus – 50,000, and in Russia –
15,000. There are also reports of a rise in cases of thyroid cancer in the South of France,
Scotland and Poland.
Because the latent period for leucosis is between several months to several years,
many cases in Ukraine, Belarus and Russia have never been registered; this is also due to
official orders to falsify such data. In spite of this, there is a visible increase in the
frequency of leukemia in all polluted areas of Ukraine, Belarus and Russia (Prysyazhnyuk
et al., 1999; Ivanov et al., 1996; Sources and Effects …, 2000).
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 3 Examples of occurrence of some solid cancers cases as a direct result of the
Chernobyl catastrophe
Location
Retinoblastoma
Lung
Intestines,
Colon, Kidneys,
Lungs,
Mammary
glands, Bladder
Respiratory
organs
Bladder
Nervous system
All cancers
Pancreas
Mammary gland
All cancers in
children
9
Region, features
A 2-fold increase in cases between
1987 and 1990 in the eye microsurgical
center in Minsk, Belarus
A 4-fold increase among 32 000
evacuees, than on the Belarus’ average
An increase in the Gomel area
(Belarus), correlated with a level of the
Chernobyl radioactive pollution
Author
Byrich et al.,
1994
An increase in the Kaluga area
(Russia), correlated with the Chernobyl
radioactive pollution
An increase in men in the Chernobyl
polluted territories in Ukraine
Increase in the liquidators in Belarus
Ivanov et al.,
1997
Increased by 76,9 % from 1986 to 1989
An increase (from 1,34 % in 1986 to
3,91 % in 1994) among adults from the
polluted territories of the Zhytomir
area, Ukraine
Up to 10-fold increase in the most
polluted areas Ukraine, Belarus and
Russia from 1986 to 1994
Increase of 1,5 in polluted Ukrainian
territories for period 1993 - 1997
In the 11 yr period after the catastrophe,
for the most polluted areas, rates (13,1 17,1 per 100,000 were higher than the
Russian average (10,5)
Exceeds the average across Belarus by
3,7 – 3,1 times for the evacuated
children and those living in the polluted
regions
Exceeded by 20 times in 1994 in the
Gomel area (heavy polluted), than in
the less polluted Vitebsk area, Belarus
Exceeds up to 15 times in 1995-1996
compared with the period 1968 – 1987
in Lipetsk city, Russia
Marples, 1996
Okeanov,
Yakimovich,
1999
Romanenko et
al., 1999
Okeanov et al.,
1996
Orlov et al., 2001
Nagornaya, 1995
Sources and
effects … 2000
Москаленко,
2003).
Ushakova, et al.,
2000).
Belookaya et al.,
2002
Bogdanovich,
1997
Krapyvin, 1997
ECRR 2006: CHERNOBYL 20 YEARS AFTER
3. Diseases of the Nervous system
Presented in Table 4 are data on the level of illnesses of the nervous system for
irradiated Ukrainian territories. Table 5 presents research that has shown a correlation
between levels of radioactive pollution and psychological diseases.
Table 4 Dynamics of diseases of the nervous system for the period 1987 - 1992 (per
100,000, adults) in territories within Ukraine, as a result of the Chernobyl catastrophe
(Nyagu, 1995)
Years
Diseases of nervous
system
Mental diseases
1987
2641
1988
2423
1989
3559
1990
5634
1991
15041
1992
14021
252
419
576
1157
5114
4931
Table 5 Examples of the occurrence and level of morbidity of psychological diseases in the
Chernobyl polluted areas
Diseases
Congenital
convulsive
syndrome
Brain circulation
pathology
General
neurological
diseases, a volume
of short-term
memory loss,
deterioration of
attention function
in school-children,
16 - 17 years.
Area, feature
Growth over 10 years in
radioactively polluted areas of
Belarus
Occurrence 6 times greater in a group
of agricultural machine operators
from heavily polluted districts of the
Gomel area, Belarus (at 27,1 % from
340 against 4,5 % from 202 in the
control group)
Increase in the polluted districts of
the Mogyliov area, Belarus
The author
Tsymlyakova,
Lavrent’ieva, 1996
Ushakov et al.,
1997
Lukomsky et al.,
1993
There is more and more evidence of a “Chernobyl dementia” phenomena (deterioration of
memory and motor skills, occurrence of convulsions, pulsing headaches), caused by the
destruction of brain cells in adult people (Sokolovskaya, 1997).
4. Cataract
In the Chernobyl territories cataracts has become a common disease. In Belarus,
especially, it often occurs at a level of pollution above 15 Ci/km2 (Paramey et al., 1993;
Edwards, 1995; Goncharova, 2000, Table 6).
10
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 6 Occurrence of cataracts at different levels of pollution in 1993 – 1994, Belarus
(Goncharova, 2000)
Year
All
Belarus
1-15 Ci/km2
More than 15 Ci/km2
1993
1994
136,2
146,1
189,6
196,0
225,8
365,9
Evacuees from
a zone more
than 40 Ci/km2
354,9
425,0
5. Urogenital system diseases
Table 7 presents examples of studies revealing a correlation between the level of
radioactive pollution and the urogenital illnesses.
Table 7 Examples of diseases of the urogenital system in the Chernobyl radioactive fallout
territories
Disease
Interruption of
pregnancy,
Gestosis,
Premature birth
Inflammation of
female genitals
Ovary, cyst,
uterus, fibroma
Menstruation
irregularities
Kidney
infections,
stones in kidney
and in urine
passages
Illnesses of
urogenital system
Infringements of
sexual
development
11
Features, area
Increase in evacuees and those living
in the polluted territories for 8 - 10
years
Increased in Ukraine through 5 - 6
years after the catastrophe
2-fold increase in Ukraine 5-6 years
after the catastrophe
3-fold increase compared with the
period before the catastrophe
(initially, strengthened menstruations
prevailed, after 5 - 6 years - poor and
rare).
In the majority of women of
childbearing age of Belarus and
Ukraine
Increase and prevalence among
teenagers, Ukraine
Higher level among 1 026 046
mothers of newborns on territories
with more than 1 Ci/km2, Belarus
Increased cases in the polluted
territories, Belarus
5 times higher level of infringements
in girls, 3 times - in boys in the
heavily polluted territories than on
Author
Golubchikov et al.,
2002; Kyra et al.,
2003
Gorptchenko et al.,
1995
Gorptchenko et al.,
1995
Nesterenko et al.,
1993; Vovk,
Mysurgyna, 1994;
Babytch,
Lypchanska, 1994
Karpenko et al.,
2003
Busuet et al., 2002
Sharapov, 2001
Nesterenko et al.,
1993
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Gynecologic
disease,
complications of
pregnancy and
births
Failures of
pregnancy,
medical abortions
Infertility
Pathology of
sperm
Sclerocystosis
Early impotence
in men (aged 25 30 years)
Structural
changes of
testiculus and
spermatogenesis
disturbancies
Lactation in 70year old women
Delay of puberty
Acceleration of
sexual
development
less polluted, Belarus
Increased during 1991-2001 in
Belarus
Belookaya et al.,
2002
Growing in the polluted areas of
Belarus
Golovko, Izhevsky,
1996
Increase of 5,5 times in the polluted
Belarusian areas in 1991 in
comparison with 1986
Increase of 6.6 times in the polluted
areas, Belarus
2-fold increase in the polluted areas,
Belarus
Increase in the polluted areas of
Belarus and Russia
Shilko et al., 1993.
In 75,6 % of the surveyed men in
Kaluga area, Russia
Pysarenko, 2003
Belarus
Alexievich, 1997
Delayed in young men (for two
years) and girls (for a year) in the
areas polluted by 90-Sr and
plutonium;
Paramonova,
Nedvetskaya, 1993
Girls (13-14 years) in the territories
polluted by 137-Cs
Paramonova,
Nedvetskaya, 1993;
Leonov, 2001
Shilko et al., 1993
Shilko et al., 1993
Shilko et al., 1993;
12
ECRR 2006: CHERNOBYL 20 YEARS AFTER
6. Cardio-vascular system and blood diseases
Diseases of the cardio-vascular system and blood are one of the most common
consequences of the Chernobyl radioactive pollution (Table 8).
Table 8 Diseases of the cardiovascular system in Chernobyls’ radioactively polluted areas
Disease
Anaemia
Illnesses of
the blood
circulation
system
Arterial
hypertensia or
hypotensia
Disturbances
of the heart’
rhythm and
the digestive
system
Macrocitosis
of
lymphocytes
Diseases of the
blood and
circulatory
organs in
adults
13
Region, features
Increase of 7 times in the
Mogyliov region; correlates
with the level of pollution in
Belarus
Level of primary illnesses have
risen by 2,5 - 3,5 times in
Mogyliov and Gomel areas,
Belarus since 1986
Increase of 3-6 times more in the
polluted districts, than the
average in the Bryansk area
More often in territories with a
level of pollution above 30
Ci/km2 in the Mogyliov area
In children, and adults correlated
with the pollution level, Belarus
Ischemic illness more frequent
and severe in the polluted areas,
Belarus
Correlated with the level of 137Cs incorporated
Increase in the polluted
territories of Belarus
6-7 times more often in the
polluted areas, Belarus
Increased by 50 times in the
polluted territories from 1986 to
1994 in the Zhytomir area,
Ukraine
Increased by 5,5 times (to a
greater degree - in the polluted
areas) in comparison with the
pre-Chernobyl level, Belarus
Raised by 3.5 times in the
Gomel area, 2.5 times - in the
The author
Hoffman 1994, p. 514;
Dzykovitch et al., 1994;
Nesterenko, 1996
Nesterenko, 1996
Komogortseva, 2001
Podpalov, 1994;
Nedvetskaya, Lyalykov,
1994; Sykorenskyi,
Bagel’, 1992; Goncharik,
1992; Zabolotny et al.,
200
Arynchyna,
Mil’kamanovitch, 1992.
Bandajevsky, 1997, 1999
Nedvetskaya, Lyalykov,
1994; Sykorenskyi,
Bagel’, 1992; Goncharyk,
1992
Bandajevsky, 1999
Nagornaya, 1995
Manak et al., 1996
Nesterenko, 1996
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Early
atherosclerosis
and ischemic
heart disease
Leucopenia
and anaemia
Infringement
of the blood
supply in legs
Changes of
leukocytes
number and
activity
Mogyliov area from 1986 level
Observed in evacuees and in
heavy polluted districts in the
Kiev area, Ukraine
Prokopenko, 2003
Increased by 7 times in
comparison with 1985 levels in
the Mogyliov area (Belarus) for
the first three years after the
catastrophe
In girls who lived in the 137-Cs
1 - 5 Ci/km2 polluted areas of
Belarus for 10 years
Lowered in pregnant women in
the polluted territories of the
Kursk area, Russia
Correlation between number of
lymphocytes and basophilic cells
with a level of 137-Cs pollution
, Belarus
Lowered in evacuees 7-8 years
after the catastrophe, Ukraine
Goffmann, 1994, p. 514
Khomitch, Lyusenko,
2002; Svanevsky,
Gamshey, 2003
Alymov et al., 2004
Miksha, Danilov, 1997
Baeva, Sokolenko, 1998
Table 9 Blood disease morbidity (per 100,000) in the adult population of Belarus, 1979 1997 (Gapanovich et al., 2001)
Acute leukemia
Chronic leukemia
Eritremia
Multiple Mieloma
Hodgkins’ disease
Non-Hodgkins’ Lymphoma
Mielodisplastics syndrome
* P <0.05
1979-1985
2,82±0,10
6,09±0,18
0,61±0,05
1,45±0,06
3,13±-0,10
2,85±0,08
0,03±0,01
1986-1992
3,17±0,11*
8,14±0,31*
0,81±0,05*
1,86±0,06*
3,48±0,12*
4,09±0,16*
0,12±0,05*
1993-1997
2,92±0,10
8,11±0,26*
0.98±0,05*
2,19±0,14*
3,18±0,06
4.87±0,15*
0,82±0,16*
7. Imbalance of hormone/endocrine statute
There is much evidence correlating endocrine/hormone imbalance with the
radioactive Chernobyl fallout. Table 10 presents data concerning the incidence rate for
Type 1 diabetes mellitus in Belarus.
14
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 10 Incidence rate of Type 1 diabetes in children and adolescents in Belarus, 1980 –
2002 (Zalutskaya et. al., 2004)
Low polluted territories (Minsk area)
Heavily polluted territories (Gomel
area)
* P <0.05
1980-1986
2,25 ±0,44
3,23 ± 0,33
1987 – 2002
3,32 ± 0,49
7,86 ± 0,56*
Table 11 presents some research showing correlations between the Chernobyl
radioactive pollution with the development of hormone/endocrine diseases.
Table 11 Endocrine/hormonal diseases in some Chernobyl polluted territories
Disease
Thyroid gland
diseases
(autoimmune
thyroiditis,
thyrotoxicosis,
diabetes
etc.)
15
Area, feature
Raised since 1992 in the
polluted territories, Ukraine
Exceeds by 600 times the preChernobyl level, Gomel area,
Belarus
Increased among 1,026 046
recently confined women from
territories with more than 1
Ci/km2, Belarus
Auto-immune thyroiditis in
children increased by nearly 3
times during the 10 years after
the catastrophe, Belarus
Congenital diabetes increased in
Belarus (before the catastrophe
there were no recorded cases)
Children goiter increased by 7
times (since 1985) by 1993 in
the Gomel area, Belarus,
In Ukraine, Belarus and Russia
a survey of children showed
diseases in 38,5 % (45,873
cases) in the 10 yrs following the
accident
In 47 % (from 3437 surveyed
children) in the Mozyrskiy
district of Gomel area, Belarus
In each second child in Bryansk
area, Russia
7,601 cases in children (among
284 cancer cases) in 1998 –
2004, Bryansk area, Russia
Author
Tron’ko et al.,,
1995
Byrjukova,
Tulupova, 1994
Busuet et al., 2002
Leonova,
Astakhova, 1998
Marples, 1996;
Zalutskaya, et al.,
2004
Astachova, et al.,
1995
Yamashita,
Shibata, 1997
Vaskevich,
Chernyshova, 1994
Kashirina, 2005
Karevskaya et al.,
2005
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Endocrine
system diseases
Concentration of
hormones
Concentration of
hormones
Prolactinemia
Increased 5 times by 2002 in
children in the polluted districts
of the Tula area, Russia
Exceeded 2,6 times the average
areas’ level in the polluted
southwest districts, adult
population, Bryansk area, Russia
Many cases of hormonal
imbalance
in the first two years after the
catastrophe in the heavily
polluted territories, Ukraine
Lowered testosterone level in the
heavily polluted territories,
Belarus
Increase concentration of Т4
and ТCG and decreases - Т3
hormones in polluted districts in
Gomel and Vitebsk areas,
Belarus
Increase of insulin level in boys
and girls, and testosterone level in girls in the polluted territories,
Belarus
Cortisol level increased in
pregnant women parallel with
the level of incorporated 137-Sr
Cortisol, thyroxin, progesterone
level in children correlated with
the level of radioactive pollution,
Belarus
Cortysol level raised in
territories with 1 - 15 Ci/km2,
and lowered in territories with a
greater level of pollution in
healthy newborns, Gomel and
Mogyliov areas, Belarus
17,7 % of the surveyed women
of reproductive age, in the
radioactively polluted Russian
territories
Sokolov, 2003
Sergeeva et al.,
2005
Stepanova, 1995
Lialykov et al.,
1993
Dudynskaya,
Suryna, 2001
Antipkin,
Arabskaya, 2001;
Leonov, 2001
Duda, Kharkevich,
1996
Sharapov, 2001
Danil’chik et al.,
1996; Petrenko, et
al., 1993
Strukov, 2003
In 1993 more than 40 % of the surveyed children in the Gomel area of Belarus had an
enlarged thyroid gland. By expert estimations, in Belarus up to 1,5 million are at risk of a
pathology of the thyroid gland (Goffmann, 1994а; Lipnick, 2004).
16
ECRR 2006: CHERNOBYL 20 YEARS AFTER
8. Immune disturbances
Additional irradiation, even at a small level, will attack the immune system. Results of
further important research carried out over recent years in Ukraine, in Belarus and Russia is
presented in Table 12
Table 12 Immunity disturbances in some of Chernobyls’ polluted territories.
Disease
Changes to
cellular and
humoral immunity
Level of
immunoglobulins
Maintenance Тand В- lymphocites
Resistance to
infections and other
diseases
Lowered immune
status
Tonsillitis,
lymphadenopaties
17
Feature, area
Decrease in immune response
in healthy adults in the
polluted territories of Belarus,
and Russia
5-fold increase of
infringements of immunity
and metabolism in children in
polluted districts of the Tula
area, Russia
Children in the polluted
territories, Russia
In healthy children living in
the polluted territories of
Belarus
Changes in the level of
immunoglobulins A, M and G
at the onset of lactation in
women from the territories
polluted by Cs-137 5 Ci/km2
in the Gomel and Mogyliov
areas, Belarus
Decreased level in adults from
the polluted areas of Belarus
Lowered in the polluted areas
of Belarus
45 % of children in the
polluted territories of Ukraine
Only 7 years after the
catastrophe was there a
normalization in children of a
number of immune
characteristics, Ukraine
In babies in the territories with
a level of pollution 5 and more
Ci/km2 , Belarus
Raised frequency and
expressiveness (45,4 % among
the 468 children and teenagers
Author
Soloshenko, 2002;
Kyril’chik, 2000;
Dubovaya, 2005
Sokolov, 2003
Terletzkaya, 2003
Soloshenko, 2002;
Kyryl’chek, 2000;
Iskrytskiy, 1995;
Zubovich et al.,
1998
Bandajevsky, 1999
Bortkevich et al.,
1996
Gurmanchuk et
al., 1995
Kharytonyk et al.,
1996
Petrova et al.,,
1993
Bozhko, 2004
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Anti-cancer
immunity
Allergies
Allergies (Cont’d)
surveyed), in the more
polluted territories, Ukraine
Lowered in children in heavily
polluted territories, and also
among evacuees, Belarus
More than twice the cows
milk proteins among 1,313
Belarusian children in the
territories 137Cs, 1 - 5
Ci/km2, than in the less
polluted territories (36,8 %
and 15,0 %).
Nesterenko et al.,
1993
Bandajevsky et al.,
1995, 1995a;
Bandajevsky, 1999
The typical consequence of infringement on the immune system in the radioactively
polluted territories appears as an immuno-deficiency and, due to an increase in frequency
and intensity of any acute and chronic diseases, is observed everywhere in the Chernobyl
polluted territories. Sometimes the weakening of the immune system in these radioactively
polluted territories is referred to as «Chernobyl AIDS».
9. Premature Ageing
There is accelerated ageing among the people in the Ukrainian radioactively polluted
territories: their biological age exceeds their calendar one by 7 - 9 years (Mezhzherin,
1996). In territories polluted above 15 Ci/km2 on 137Cs in Belarus the mean age of men
and women who died from heart attacks was 8 years younger than the average across
Belarus (Antypova, Babichveskaya, 2001).
The array of diseases commonly considered exclusive to the elderly is typical for
children in all of the heavily polluted territories. The immune system activity of these
children is similar to the type of immune system activity experienced in old age.
(Mezhzherin, 1996). The pathology of the digestive system epithelium in children from the
polluted areas of Belarus also shows similarities with elderly people (Nesterenko, in litt.).
Among 69 children and teenagers hospitalized in Belarus in 1991 - 1996 with alopecia,
more than 70 % were from polluted territories (Morozevich et al., 1997)
10. Growing mutation rate
There are many studies showing a wide range of chromosomal aberrations in the
Chernobyl radioactively polluted areas. A cytogenetic examination of inhabitants in the 30km Zone shows that the frequency of aberrant cells and chromosomal aberrations for
inhabitants in the Zone are significantly higher than those for the residents in the Kiev
region, while the values of the latter group were found to be above the spontaneous and preChernobyl levels (Table 13, Table 14).
18
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 13 Comparative frequency (per 100 lymphocytes) of aberrant cells and chromosomal
aberrations for Ukraine and the World
Ukraine, early 70-ies
aberrant
cells
Na
chromosomal
aberrations
1.19±0.06
Ukraine, before 1986
1.43±0.16
1.47±0.19
The world generalized level,
2000
Ukraine, Kiev region, 1998-1999
30-km Zona, 1998-1999
2.13±0.08
2.21±0.14
3.20±0.84
5.02±1.95
3.51 ±0.97
5.32±2.10
Authors
Bochkov et
al., 1993
Pilinska et
al., 1999
Bochkov et
al., 2001
Bezdrobna
et al., 2002
Table 14 Frequency (per 100 cells) of chromosomal aberrations in the Exclusion Zone
inhabitants and residents in the Kiev area (Bezdrobna et al., 2002)
Chromatid type
Fragments
Dicentrics + centric
rings
Abnormal
monocentrics
Total chromosome
type
30-km zone
3.14 ± 0.24
1.59 ± 0.20
0.33 ± 0.06
Kiev area
2.33 ± 0.12
0.89 ± 0.12
0.13 ± 0.03
0.23 ± 0.05
0.12 ± 0.03
2.16 ± 0.24
1.18 ± 0.13
There is a growth in the level of some chromosomal aberrations in the 30-km Zone
inhabitants over time (Table 15).
Table 15 Dynamics of frequency (per 100 cells) in different types chromosomal aberrations
in the lymphocytes of the 30-km Zone residents (the same 20 persons) (Bezdobna et al.,
2002)
Breaks
Exchanges
Dicentric + centric rings
Total chromosome type
* P <0.05
1998 - 1999
3.00 ± 0.33
0.16 ± 0.07
0.39 ± 0.09
2.58 ± 0.35
2001
3.53 ±0.40
0.29 ± 0.07
0.45 ± 0.09
1.63 ± 0.16 *
A comparison of the results of all the above mentioned cytogenetic examinations,
together with many others presented in Table 16, allows us to assume the activation of
mutagenesis in the regions with any level of the Chernobyl radioactive pollution.
19
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 16 Examples of chromosomal aberrations and other genetic effects of the Chernobyl
fallout
Character
Feature, area
Increase by 2-4 times in territories with
pollution more than 3 Ci/km2, Ukraine,
Russia
Increase in the radioactively polluted
territories, Belarus, Ukraine
Frequency of
chromosomal
aberrations in
somatic cells
Correlates with the level of radioactive
pollution in Ivano-Frankovsk area,
Ukraine
More in thyroid cancer cells than in
normal somatic cells in the polluted
territories
More in children irradiated in utero ,
Ukraine
Number of
mitosis
(mitotic index)
Mutations in
satellite DNA
Chromosomal
aberrations and
satellite DNA
mutations
Chromosomal
mutations de
novo.
For children living in territories with 15
Ci/km2, unstable chromosome
aberrations remained at a high level for
16 years; stable aberrations developed
over the period
Lower in polluted districts of Bryansk
area, Russia
Author
Bochkov, 1993
Nesterenko, 1996,
Goncharova, 2000;
Maznik, Vinnikov,
2002; Maznik,
2003; Lyazuk et
al., 19944
Sevan’kaev et al.,
1995; Ivanenko et
al., 2004
Sluchick et al.,
2001
Polonetskaya et al.,
2001
Stepanova, 1995;
Stepanova et al.,
2002
Pilinska et al.,
2003
Pelevina et al.,
1996
2-fold increase in children whose
parents lived in the polluted territory of
the Mogyliov region of Belarus ;
correlated with the level of pollution,
Belarus
More in children with thyroid cancer
Dubrovа, Jeffreys,
1996; Dubrova,
2002; Dubrova et
al., 1996; 1997,
2002
Melnov et al.,
1999
Increase in the polluted territories,
Belarus
Lazjuk et al., 2001
20
ECRR 2006: CHERNOBYL 20 YEARS AFTER
11. Infection and infestation
In the Chernobyl radioactively polluted territories (compared with clean
territories) increasing morbidity by intestinal toxicosis, gastro-enteritis, dysbacteriosis,
sepses, virus hepatitis and respiratory viruses was observed (Batyan, Kozharskaya, 1993;
Kapytonova, Kryvitskaya, 1994; Nesterenko et al., 1993; Kul’kova et al., 1996; Busuet et
al., 2002; Antonov,Ostreiko, 1995; Goudkovsky et al., 1995). Several examples of such
studies are presented in Table 17.
Table 17 Examples of some infectious and parasitic diseases observed in the Chernobyl
radioactively polluted territories
Disease
Herpes virus
infections
Feature, area
Active in the radioactively polluted
territories, Belarus
Trichocephalisis
(Trichocephalis
trichiurus)
Pneumocistis
(Pneumocystis
carinii)
Increased correlation with density of
radioactive pollution in the Gomel and
Mogyliov areas, Belarus
Increase in children in the polluted
territories, Russia
Cryptosporidosis
(Cryptosporidium
parvum)
Raised in radioactively polluted
territories in the Bryansk, Mogyliov
and Gomel areas of Russia and Belarus
Increased frequency and intensity in the
polluted areas of Belarus.
Occurrence of medicine-resistant forms
and “rejuvenation” {sic} diseases in the
polluted territories of Belarus
2-fold increase (above Byelorussian
mean level) in polluted territories of
the Gomel and Mogyliov areas, during
the 6 - 7 years after the catastrophe
An increase among adults and
teenagers in the polluted territories of
Vitebsk area, Belarus
Active in pregnant women in the
radioactively polluted territories,
Belarus
Tuberculosis
(Mycobacterium
tuberculosis)
Viral hepatits
Cytomegalovirus
(CMV) Infection
(Cytomegalovirus
hominis )
Author
Matveev et al.,
1993;
Voropayev et
al., 1996
Stepanov,
1993
Lavdovskaya
et al., 1996
Lavdovskaya
et al., 1996
Belookaya,
1993
Borschevsky,
1996
Matveev, 1993
Zhavoronok et
al., 1998
Matveev, 1993
Microsporia (Microsporum sp.) occur in the radioactively polluted territories of
the Bryansk areas (Russia) more frequently and in a more virulent form (Table 18).
21
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 18 Microsporia cases (per 100 000) in three heavily radioactively polluted districts of
the Bryansk area, Russia, 1998 - 2002 (Rudnytzkyi et al., 2003).
Years
1998
1999
2000
2001
2002
Polluted districts
56,3
58,0
68,2
78,5
64,8
"Pure" districts
32,8
45,6
52,9
34,6
23,7
12. Children’s health
There are increases in children’s general morbidity, and also increases in rare
illnesses in the Chernobyl polluted territories of Ukraine, Belarus and Russia (Nesterenko et
al., 1993).
In Belarus, unique inspections of the same children were conducted in 1995 - 1998
and in 1998 - 2001 (Arynchin et al., 2002). One group (n - 133, 10,6 years) was from the
heavily radio-contaminated territories, and the second (n - 186, 9,5 years - from low
polluted territories. Results of the children’s self-estimation of their health are presented in
Table 19, and results of clinical inspection are presented in Table 20.
Table 19 Dynamics of children’s complaints, from heavily and low irradiated territories of
Belarus, (%) concerning their health (Arynchin et al.,2002)
Heavy irradiated territories
1995-1998
1998 - 2001
72.2
78.9
31.6
28.6
12.8
17.3
37.6
45.1
0.8
2.3
2.3
3.8
27.1
23.3
1.5
18.8*
51.9
64.7*
9.8
15.8
1.5
7.5*
9.0
14.3
Total complains
Weakness
Dizziness
Headache
Syncope
Nasal bleeding
Fatigability
Heart arrhythmia
Stomachache
Belching
Heartburn
Decreased
appetite
Allergic eruptions 1.5
3.0
*P <0.05; ** Р <0.05; *** Р <0.05.
Low irradiated territories
1995-1998
1998 - 2001
45.7 **
66.1 *, ***
11.9 **
24.7*
4.9 **
5.8 ***
20.7 **
25.9 ***
0
0
0.5
1.2
8.2 **
17.2*
05
.8 *, ***
21.2 **
44.3 *, ***
2.2 **
12.6*
1.6
5.8*
1.1 **
10.3*
0.5
5.8*
22
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 20 Dynamics of clinical syndromes (%) and diagnoses for the same children (see
Table 19) from the heavily and low irradiated territories of Belarus (Arynchin et al., 2002)
It is clear that children in heavily radio-polluted territories really do suffer, to a much
greater degree, from a variety of diseases.
Clinical
syndromes and
diagnosis
Chronic gastritis
Chronic
duodenitis
Chronic gastroduodenitis
Bilious dyskinesia
Vegeto-vascular
and cardiac
syndrome
Astheno-neurotic
syndrome
Chronic tonsillitis
Caries
Chronic
periodontitis
Heavy irradiated territories
Low irradiated territories
1995 – 1998
44.2
6.2
1998 – 2001
36.4
4.7
1995 - 1998
31.9
1.5
1998 - 2001
32.9
1.4
17.1
39.5*
11.6
28.7*
43.4
67.9
34.1
73.7
17.4 **
40.3 **
12.6 ***
52.2 ***
20.2
16.9
7.5 **
11.3
11.1
58.9
6.8
9.2
59.4
2.4
13.6
42.6 **
0 **
17.2 ***
37.3 ***
0.6
*P <0.05; ** Р <0.05; *** Р <0.05.
Practically all forms of studied nosology are more prevalent in the main group
compared to the control during both the first and the second examinations. Data of Table 19
and Table 20 give a convincing picture of sharply worsening health in children from the
polluted territories.
Some examples of other investigations into children’s health in the polluted
territories are presented in the Table 21.
23
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 21 Spectrum of children’s non-cancer illnesses in the Chernobyl radioactively
polluted territories
Disease
Total child
morbidity
Newborn
morbidity
The lowered
weight of
newborns
Circle of head
Infringements of
rate of physical
development
Premature birth
invalided
Children
Rate of growth
Cataract
Retinal diseases
Feature, area
Increase 2,9 times with 1986 on
2001, Ukraine
More intensive growth in the
polluted territories of Kaluga area,
Russia
2-fold increase above the mean in
the Bryansk area in the polluted
territories in 2004
Annual growth in Belarus on 9,5 % ;
the highest - in the most polluted
Gomel area
Irradiated in utero, Ukraine
Less in newborns in the polluted
territories of Ukraine and Belarus
Irradiated in utero, Ukraine
In the polluted territories, Belarus
More often in the polluted
territories, Belarus
351,9 (per 10 000), 1998 – 1999 in
three polluted districts of the area
(173,8 – in Bryansk area, 160, 7 Russia)
Delay in the radioactively polluted
territories, Belarus
Correlation between level of
frequency and intensity within the
radioactive pollution of territories,
Belarus
Correlation between frequency and
level of incorporated 137Cs, Gomel
area, Belarus
Occurs 6,2 % in 1985, 17,0 % in
1989 (4,797 children from two
polluted districts of the Gomel area
(137Cs up to 23 Ci/km2), Belarus.
Author
Moskalenko, 2003
Ignatov et al., 2001
Sergeeva et al.,
2005
Dzykovich et al.,
1996
Stepanova, 1995;
Zakrevsky et al.,
1993
Loganovsky, 2005;
Akulich et al., 1993
Ushakov et al.,
1997
Sharapov, 2001
Tsymlyakova,
Lavrent’eva, 1996
Komogortseva,
2001
Antipkin,
Arabskaya, 2001
Paramey et al.,
1993; Edwards,
1995; Goncharova,
2000;
Bandajevsky, 1999
Byrich et al., 1999
24
ECRR 2006: CHERNOBYL 20 YEARS AFTER
12.1. Children’s respiratory system diseases
Respiratory system diseases occurred everywhere in the Chernobyl radioactively
polluted territories (Table 22).
Table 22 Children’s respiratory system diseases in the Chernobyl polluted territories
Respiratory
syndrome
Suffocation
(asphyxia)
Bronchial
conductivity
Latent
bronchospasm
Bronchial asthma
Chronic bronchitis
Nasopharyngeal
chronic pathology
Acute respiratory
diseases
25
30 % of children in the polluted
territories in the first months after
the catastrophe, Ukraine
Correlation frequencies with level
of radioactive pollution in the
Gomel area, Belarus.
Children who at the moment of the
catastrophe were 0 - 4 years,
suffered more often in territories
with 15 - 40 Ci/km2, than in
territories with 5 - 15 Ci/km2.
In half of the 345 surveyed
newborns irradiated in utero,
Ukraine
In 53,6 % children in the polluted
territories (surveyed more than 110
000) against 18,9 % on the low
polluted territories, 1986 – 1987,
Ukraine
In 69,1 % of children from the
polluted territories (among more
than 110, 000 surveyed) against
29,5 % in the lesser polluted
territories, 1986 – 1987, Ukraine
Number of cases higher in the
polluted territories, Belarus
Heavier expression in the polluted
territories, Russia
Heavier expression in the polluted
territories, Russia
1.5 - 2 times more often in the
polluted territories, Belarus
2-fold in those irradiated in utero
Stepanova,
1995
Goudkovsky et
al., 1995
Kul’kova et al.,
1996
Zakrevsky et
al., 1993
Stepanov et al.,
1995
Dzykovich et
al., 1996;
Sitnikov et al.,
1993
Terletskaya,
2003
Dzykovich et
al., 1996;
Sitnikov et al.,,
1993
Nesterenko,
1996
ECRR 2006: CHERNOBYL 20 YEARS AFTER
12.2. Children’s Blood and lymphatic systems diseases
Cardiovascular system diseases in children occurred more frequently in the
polluted territories. Table 23 presents data on the dynamics of reduction in the rate of blood
formation in children after the catastrophe of Belarus.
Table 23 Reduction in the rate of blood formation in children from Belarus (Gapanovich et
al., 2001)
The total cases of pre-leukemia
conditions
Annual number of cases
The standardized parameter
(per 10 000)
1979-1985
65
1986 – 1992
98
1993
78
9,3
0,60±0,09
1,00
14,0
0,71±0,1*
1,46 *
15,6
1.73*
Data on children’s diseases of the respiratory system in the radioactively polluted territories
are presented in Table 24.
Table 24 Occurrence of children’s blood and lymphatic system diseases in the Chernobyl
polluted territories
Disease
Infringements
of cardiac
rhythm
Infringements
of vegetative
regulation of
cardiac activity
Feature, area
In more than 70 % of children with an
average age of one year, in the territories 5 20 Ci/km2, Ukraine
In children from the polluted territories of
Belarus
Arterial
hypertension
Correlated with a level of the incorporated
137-Cs in Gomel area, Belarus
Number of Вand Т-lymphocytes
Lymphopenia
Correlation with a level incorporated 137Cs in the Mogyliov and Gomel areas,
Belarus
In children 10 - 13 years old in heavily
polluted territories of Kursk area, Russia
Increase of cases in the polluted territories,
Belarus, Russia
Author
Tsybul’skaya
et al., 1992
Nedvetskaya,
Lialykov,
1994;
Sykorenskyi,
Bagel’, 1992;
Goncharik,
1992
Kienya,
Ermolitsky,
1997
Dzykovich et
al.,
1996;
Nesterenko,
1996;.
Bandajevsky,
1999; Khmara
et al., 1993;
Alymov et al.,
2004
Lukianova,
Lenskaya,
1996;
Sharapov,
26
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Bradycardia
Lymphoid
hyperplasia
Hematological
disease
Heart
conductivity
Elasticity
of
arterial vessels
More often in children and teenagers in the
polluted territories, Ukraine
Occurred in 30 % children in the heavily
polluted territories in the first months after
the catastrophe, Ukraine
Occurred in 90 % of children in heavily
polluted territories in the first months after
the catastrophe, Ukraine
Raised frequency among 1,220,424
newborns in the territories more than 1
Ci/km2, Belarus
In 3,7 - 6,9 times above (compared to other
areas) in the three most polluted districts of
Bryansk area, Russia
Raised more than twice in 2002 in heavily
polluted districts of the Tula area, Russia
The level of infringements correlated with
radioactive pollution of territories, Belarus
Declining in all children (including
‘healthy’ children) in the polluted territories
of the Gomel and Brest areas, Belarus
2001; Vasyna
et al., 2005
Kostenko,
2001
Stepanova,
1995
Stepanova,
1995
Busuet et al.,
2002
Komogortseva,
2001
Sokolov, 2000
Bandajevsky,
1997, 1999
Arynchin
et
al., 1996
12.3. Dental system diseases
Dental diseases in children are more frequent in the Chernobyl radioactively
polluted territories (Table 25).
Table 25 Occurrence of dental diseases in children in the Chernobyl polluted territories
Disease
Caries
Feature, area
Raised prevalence and intensity in children
and teenagers in more polluted territories,
Belarus and Russia
Enamels acid
resistance
Paradont
pathologies
Combinations
of anomalies
of dental
systems
Lowered in more polluted territories,
Belarus
Greater intensity in those irradiated in utero,
Russia
Greater intensity in those irradiated in utero;
greater frequency in the polluted territories,
Russia
Author
Mel’nichenko,
Cheshko,
1997;
Sevbitov, 2005
Mel’nichenko,
Cheshko, 1997
Sevbitov, 2005
Sevbitov, 2005
Frequencies of some dental diseases correlate with the level of radioactive pollution (Table
26).
27
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 26 Frequency of dental anomalies (%) in children in territories with different levels
of radioactive pollution (Tula and Bryansk areas, Russia), * (Sevbitov et al., 1999).
Teeth
anomalies
Up to
Ci/km2
3,7
5
5-15 Ci/km2
15-45 Ci/km2
2,4
2,8
Children born
Before
1986
(n=48)
4,2
4,6
6,3
After
1986
(n=82)
Teeth row 0,6
0,4
0,6
Before
1986
anomalies
(n=8)
0,6
0,6
1,7
After
1986
(n=15)
Occlusion
2,6
2,4
2,2
Before
1986
(n=39)
4,4
5,2
6,3
After
1986
(n=86)
Age norm
5.3
5,7
3,1
Before
1986
(n=77)
2,6
2,0
0,6
After
1986
(n=28)
* 5 Ci/km2 - Don, the Tula area (183 persons); 5 - 15 Ci/km2 - Uzlovaya, Tula area (183
persons); 15 - 45 ¬ Ci/km 2 - Novozybkov, Bryansk area (178 persons).
12.4. Congenital malformations
Congenital malformations (CM), such as cleft lip and/or palate ("hare lip”),
doubling of kidneys, polydactyly, anomalies in the development of nervous and blood
systems, amelia (limb reduction defects), anencephaly, spina bifida, esophageal and
anorectal atresia, multiple malformations etc., have increased in the Chernobyl
radioactively polluted territories (Lazjuk et al., 1997; 1999; Surykov, 1996; Goncharova,
2000, Ibragimova, 2003; Dubrova et al., 1996, and many others).
Table 27 presents the CM frequency of children who were born 1 - 3 years after
the catastrophe in 15 districts with more than 15 Ci/km2 by Cs-137 pollution, and in Table
27 - the generalized data across Belarus.
Table 27 Frequency of congenital malformations (per 1,000 born alive) in the 15 districts
of Gomel and Mogyliov areas, Belarus, who were born before and after the Chernobyl
catastrophe (Nesterenko, 1996)
Braginsky
Buda-Koshelevsky
Vetkovsky
Dobrushinsky
El’sky
Kormyansky
1982-1985
Gomel
4.09 ± 1.41
4.69 ± 1.21
2.75 ± 1.04
7.62 ± 1.96
3.26 ± 1.35
3.17 ± 1.20
1987-1989
area
9.01±3.02
9.33±2.03*
9.86±2.72
12.58±2.55
6.41±2.42
5.90±2.08
28
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Lel’tchitsky
Loevsky
Khoyniksky
Chechersky
3.28 ± 1.16
1.56 ± 1.10
4.37 ± 1.16
0.97 ± 0.69
Mogelyov
Bykhovsky
4.00±1.07
Klymovichsky
4.77±1.44
Kostjukovichsky
3.00±1.22
Krasnopol’sky
3.33±1.49
Slavgorodsky
2.48±1.24
Cherykovsky
4.08±1.66
All territories
3.87±0.32
* Р>0.05; ** Р>0.01; *** >Р 0.001
6.55±1.98
3.71±2.14
10.24±2.55*
6.62±2.33*
area
6.45±1.61
3.20±1.43
11.95±2.88 **
7.58±2.85
7.61±2.68
3.59±1.79
7.19±0.55 ***
Table 28 Occurrence of congenital malformations (per 1,000 born alive) in the territories
with different levels of Chernobyl radioactive pollution, Belarus
(Lazjuk et al., 1999)
Anencephaly
Spina bifida
Cleft lip and/or palate
Polydactyly
Limb reduction
defects
Down’s syndrome
Multiple
malformations
Total
*Р>0.05
≥15 Ci/km2, 17 districts
1982-1985 1987 - 1995
0,28
0,44
0,58
0,89
0,63
0,94
0,10
1,02*
0,15
0,49*
<1 Ci/km2, 30 districts
1982-1985 19987 – 1995
0,35
0,49
0,64
0,94*
0,50
0,95*
0,26
0,52*
0,20
0,20
0,91
1,04
0,84
2,30*
0,63
1,18
0,92*
1,61*
3,87
7,07*
3,90
5,84*
Table 29 presents data on the occurrence of genetic malformations in the polluted
territories, such as Belarus, Russia and Ukraine (for other countries see paper by Inge
Schmitz-Feuerhake in this book).
29
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 29 Occurrence of congenital malformations (CM) in the Chernobyl polluted
territories
Character
Central Nervous
system CM
All cases registered
CM
Down’s
syndrome
Eye CM
Feature, area
Increase among newborns who have
died between 1987 - 1995 in the
polluted areas, Belarus
Increased frequency of dropsy of the
brain -19,6 %, brain tumor
(medulloblastoma) - 59,6 % from
1987 to 1992 , Ukraine
Increase in legal abortions in the
polluted areas, Belarus
Increase in the polluted territories of
Bryansk and Tula areas, Russia
2-fold increase among children
irradiated between 4-6 months in
utero, than irradiated earlier and
later, Belarus
1,8 increase in the polluted territories
between 1985-1999 in the Zhytomir
area, Ukraine
Increase annually up to 2,500 with a
peak in 1990, Ukraine , Belarus
Increase among those irradiated in utero,
Ukraine
Increase in the more polluted territories of
Bryansk area, Russia
Increase among abortions in the heavily
polluted territories, Belarus
Rise of frequency in January 1987 in the
Gomel and Minsk areas, Belarus
4-fold increase in 1988 - 1989 compared to
1961 - 1972 in the Gomel area, Belarus
Author
Dzykovich,
1996
Orlov, 1993
Lazjuk et al.,
1997
Ljaginskaja,
Osypov, 1995;
Ljaginskaja et
al., 1996;
Lomat’, 1996
Fedoryshin et
al., 2001
Golubchikov et
al., 2002; Orlov,
1995;
Goncharova,
2000; Lazjuk et
al., 1997
Stepanova,
1995
Kapustina, 2005
Ljaginskaja et
al., 1997
Lazjuk et al.,
2002
Byrich et al.,
1999
30
ECRR 2006: CHERNOBYL 20 YEARS AFTER
12.5. Mental disorders
Disorders of intellectual development in children irradiated in utero and/or caused
by irradiation in the polluted territories are the most tragic consequences of the Chernobyl
catastrophe’s impact on health (see also paper by Konstantin Loganovsky in this book).
Irradiated children have not kept pace with other children (Table 30).
Table 30 Number of children (%) with revealed deviations of intellectual development in
the radioactively polluted territories of Ukraine, Belarus and Russia
(Medical consequences..., 1995; Prilipko et al., 1995)
Tests
«Man
Group of Picture»
children
Belarus (n = 1861)
Polluted 3.2
Clean
3.0
Russia (n=1025)
Polluted 5.7
Clean
4.7
Ukraine (n=1347)
Polluted 4.3
Clean
2.6
Degree of nervous disorders
Raven
color
matrixes
«British
Ratter Scale Ratter scale B(2)
dictionary» A(2)
17.2
15.1
31.6
20.6
42.7
26.6
34.3
33.3
5.9
2.0
12.9
2.7
50.0
33.3
50.0
33.3
10.9
3.5
7.2
4.9
53.9
29.9
63.2
33.5
Children 6 - 7 years old born in May – February, 1987 whose mothers were evacuated
from a zone more than 40 Ci/km2, or lived in a zone 5-40 Ci/km2 irradiated in utero,
suffered a greater frequency of neurotic disorders, CNS pathology and delay of mental
development than children in the not so polluted (“clean”) areas of Belarus (Table 31).
Table 31 Influence of irradiation in utero on the children’s intellectual development,
Belarus
(Gaiduk et al., 1994; Kolominsky, Igumnov, 1994)
Character
Neurotic disorders
Asthenic syndrome
Vegetative dystonia
CNS organic pathology
Delay of mental
development
EEG Pathology: slow type
*P> 0.01; ** P> 0.001.
Irradiated (n - 154)
36,40 ± 3,88
53.5
76.6
20,80 ± 3,15
18,80 ± 3.15
Control group (n - 90)
13,30 ± 3,58*
15.6**
33.3*
6,70 ± 2,63**
7,80 ± 2,82*
31.2
2.2
Some publications testifying to the Chernobyl irradiation impact on intellectual
and mental development are briefly listed in Table 32.
31
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 32 Summary data on the Chernobyl irradiation impact on psychological development
of children
Character
Features, area
Author
Delay of
In children irradiated in
Belookaya, 1993; Bugaev et
speech ability,
utero , Belarus, Ukraine
al., 1993; 1995; Basyl’chik,
lowered
Lobach, 1995; Nyagu,
psycho Loganovsky, 1998;
emotional
Kolominsky et al., 1999;
development,
Basyl’chik et al., 2001; Nyagu
low IQ indices
et al., 2002;
In children 5-6 years old
Pasechnik, Chuprykov, 1993;
irradiated in utero, Ukraine
Deviations in
In almost 30 % irradiated in Stepanova, 1995
mental
utero, Ukraine
development
More frequent in those
Ermolyna, Suchotina, 1995
irradiated in utero
(comparison of 895 children
who were born 1984 –
1990) in Tula area, Russia
delayed mental irradiated in utero, Ukraine
Zapesochnyi et al., 1995
development,
memory
impairment,
immaturity for
school
Organic
2 % of those irradiated in
Nyagu, Loganovsky, 1998
pathology of a
utero among evacuees,
brain
Ukraine
Decreased
In those irradiated in utero
Ulyanova et al., 1995
psychomotor
at 8 - 25 weeks of
development
pregnancy, Novozybkov
city, Bryansk area, Russia
Character of
Distinctions between
Korsakov, 2005
neurological
children 12-13 years old in
reactions
the heavily and the lesser
polluted territories of
Bryansk area, Russia
Epilepsy and
Increase in children
Chuprykov et al., 1996
epilepsyevacuated from Pripyat city,
related
Ukraine
condition
Intellectual
Children 7-9 years old,
Stepanov et al., 1993;
insufficiency
correlation with level of
Igumnov et al., 1993
irradiation in utero ,
Belarus, Ukraine
Delay of 0,5 Irradiated in utero (370
Tereschenko et al., 1992
1,5 years in
children, studied at the age
32
ECRR 2006: CHERNOBYL 20 YEARS AFTER
speech
development; a
delay of
psychomotor
development;
decreased
threshold of
convulsive
readiness,
backlog of
psychomotor
development
Schizophrenia
of 3,5 - 5 years), Belarus
Highest rate among
children born in the polluted
territories
Increase in all irradiated
groups
Ermolyna., 1994
Loganovsky, Loganovskaya,
2000
Official explanations of this deep infringement on the mental ability of irradiated
children claim that it is the result of stress, not the impact of irradiation. However, stress
does not lead to schizophrenia, epilepsy or organic damage of the brain.
13. Case study: Ukrainian district post-Chernobyl health
The above listed morbidity, by separate groups of illnesses, does not give us the full picture
of the devastation in health occurring in the Chernobyl radioactively polluted territories. In
an attempt to observe such a picture, Table 33 presents some health statistics for one remote
Ukrainian administrative district from the Zhytomir area – Lugyny district. The Lugyny
administrative district is situated 110 km South-West of Chernobyl NPP. The population in
1986 was 29,276, and in 1996 - 22,552, including 4,227 children. 22 villages are situated in
this territory with 1-5 Ci/km2 and 26 villages situated in the territory with < 1 Ci/km2. All
medical information for this study was collected by the same persons, with the same
equipment and protocols before and after the catastrophe in Central District Hospital in
Lugyny.
Table 33 Dynamics of Health Status of Residents of Lugyny District ten years after the
Chernobyl catastrophe (Godlevsky, Nasvit, 1999).
1984 1995 1985
1996
Remaining life after diagnosis of lung and stomach cancers
38 – 62
2 – 7,2
(months)
Detection of the first phase of destructive tuberculoses (% to total
17,2 –
41,7 –
tuberculosis first time detected, per 100 000)
28,7
50,0
Endocrine pathology (per 1000 children)
10,
90 – 97;
Goiters (per 1000 children)
not
12 – 13
register
Neonatal morbidity (per 1 000):
25 – 75
330 –
340
Total mortality (per 1 000)
10.9
15,5
Life expectancy
75 years
65 years
33
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Fig. 1 presents the annual rate of congenital malformation in the Lugyny district area.
Fig. 1. Annual rate of congenital malformations in the Lugyny district area (Godlevsky,
Nasvit, 1999).
I have reviewed above only a small part of the existing data on public health after the
Chernobyl catastrophe. Examining data concerning the consequences for public health
following the Chernobyl catastrophe does not give cause for optimism: mortality and
morbidity in the polluted territories will continue to grow. This conclusion is based (among
other arguments) on:
• A growing contribution to the collective dose in territories with a small density of
radioactive pollution;
• Increasing (instead of decreasing) radioactive impact (dose and dose rate) due to
increasing internal irradiation;
• The end of the latent period for several cancer diseases;
• Intensification of many non-cancer illnesses as a result of damage to the immune
system and deepening of genetic instability.
Each year it has become clearer that the real consequences of this catastrophe are much
more widespread and severe than has been predicted by the nuclear industry’s adepts. In
spite of this we, far from understanding the complete picture of the consequences of the
Chernobyl catastrophe, are justified in saying that this catastrophe really is on a global scale
and will continue to be so for many hundreds of years.
A better estimate is needed of the real health consequences of the catastrophe to
mitigate these consequences as best we can. But, at minimum, the following is urgently
required:
• An intensification and a broadening (instead of a reduction – as has happened over
recent years in Russia, Ukraine and Belarus) of medical, ecological and
radiological investigations;
• A strengthening and enrichment of the system of medical clinics and hospitals all
over the polluted territories;
34
ECRR 2006: CHERNOBYL 20 YEARS AFTER
•
•
An assessment for each irradiated person of his/her real individual dose and, from
this base, create a lifespan plan of medical support for each person.
Policy makers have to look the truth in eyes. Instead of the pro-Nuclear slogan
“It’s time to forget Chernobyl” another one is needed: “It’s time to find ways to
live with Chernobyl- forever”.
References
Akulich N.S., Gerasymovich G.I. 1993. Indices of physical development of newborns after
law dose irradiation. “Belarusian Children Health under modern ecological
conditions (Consequences of the Chernobyl catastrophe)”. VI Pediatric Congress
of Belarus, Coll. Papers, Minsk, p.9 (in Russian).
Alexievich S. 1997. Chernobyl prayer (chronic for future). Moscow, Publ. “Ostozh’e”,
223 p. (in Russian).
Alymov N.I., Pavlov A.Yu., Sedunov S.G., Gorshenin A.V., Popovich V.I., Loskutova
N.D., Belobrovkin E.A. 2004. Immune system at person living on the Chernobyl
irradiated territories. Russ. Sci.- Pract. Conf.: «Med.- Biol. Problems of Radioand Chemical Protection., 20 - 21 May, 2004, Sant-Peterburg, Russia”, , Coll.
Papers, Sank-Peterburg, pp. 45 – 46 (in Russian).
Antipkin Yu.G., Arabskaya L.P. 2001. 3rd Int. Conf. “Medical consequences of the
Chernobyl catastrophe: the results of 15 years investigations”, 4 - 8 June, Kiev,
Ukraine”, Abstracts, Kiev, pp. 151 – 152 (in Russian).
Antonov E.Z., Ostreiko N.N. 1995. Lymph-adenoid ring’ condition and children’
enterobiosis in Gomel. Int. Sci. Conf. devoted by 5-th years establishing of the
State Gomel Med. Ins., 9 – 10 November, 1995, Gomel, Belarus”, Materials,
Gomel, pp. 86 – 87 (in Russian).
Antypova S.I. Babichevskaya A.I. 2001. Belarusian adult mortality of the evacuees. 3rd Int.
Conf. “Medical consequences of the Chernobyl catastrophe: the results of 15-years
Researches, 4 - 8 June, 2001, Kiev, Ukraine”, Abstracts, Kiev, pp. 152 – 153 (in
Russian).
Arynchin А.N., Krotkaya N.А., Bortnik О.М. 1996. Brain circulation at children living on
the radioactive contaminated territories of Belarus. Inter. Sci. Conf.: “10 years
after the Chernobyl catastrophe (scientific aspects of problem). 28 - 29 February
1996, Minsk, Belarus”, Abstracts, Minsk, p. 13 (in Russian).
Arynchin A.N., Avhacheva T.V., Gres N.A., Slobozhanina E.I. 2002. Health State of
Belarusian Children suffering from the Chernobyl Accident: Sixteen Years after
the Catastrophe. In: Imanaka T. (Ed.). Recent Research Activities about the
Chernobyl Accident in Belarus, Ukraine and Russia. Res. Reactor Institute, Kyoto
University (KURRI-KR-79), Kyoto, pp. 231- 240.
Astachova L.N., Demidchik E.P., Polyanskaya O.N. 1995. The main radiation risk’ system:
Thyroid carcinoma at Belarusian children after the Chernobyl accident. IV Int.
Conf. : “Chernobyl catastrophe: Prognosis, prophylactics, treatment and medicalpsychological rehabilitation of suffers.” Collect. Materials., Minsk, pp. 119 — 127
(in Russian).
Babych T., Lypchanska L.F. 1994. State of hyphophisis – thyroid system women under low
radiation impact. “Functional methods in obstetrician and gynecology”, Sci.Pract. Conf. Ukrainian obstetr.-gynecologists, 19—20 May, 1994, Donetsk,
Ukraine”, Abstracts, Donetsk, p. 9 (in Ukrainian).
Baeva E.V., Sokolenko V.L. 1998. Т-lymphocyte’s surface marker’s expression after low
dose irradiation. Immunol., № 3, pp. 56 - 59 (in Russian).
35
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Basyl’chik S.V., Lobach I.V. 1995. Children’s intellectual development after ionizing
radiation of radio-Iodine nuclides in utero and in the first year of life with
connection of the Chernobyl accident. Sci. Conf.: “Actual and prognosis
disturbances of the psychic health after nuclear catastrophe in Chernobyl, 24 - 28
May, 1995, Kiev, Ukraine”. Materials, Kiev, Assoc. “Chernobyl Doctors”, p. 306
(in Russian).
Bandajevsky Yu.I., Kapytonova E.K., Troyn E.I. 1995. Expression of allergy to cow milk
proteins and cortisol level in blood at children from the radionuclides polluted
territories. In: “Actual problems of Immunology and Allergology.”, III Congress
Belarus. Sci. Soc. Immun. Allerg., Abstracts, Grodno, p. 111 (in Russian).
Bandajevsky Yu.I. 1999. Pathology of incorporated ionizing radiation. Gomel State Med.
Inst. Minsk, 136 p. (in Russian).
Batyan G.M., Kozharskaya L.G. 1993. Juvenile rheumatoid arthritis at children from the
radioactively polluted areas. VI Byelorussian Pediatric Congr.: “Byelorussian
children’ health under modern ecological condition (Consequences of the
Chernobyl catastrophe).” Materials, Minsk, pp. 18—19 (in Russian).
Belookaya T.V., Koryt’ko S.S., Mel’nov S.B. 2002. Medical effects of the low doses of
ionizing radiation. 4th Int. Congress on Integrative Anthropology, Materials,
Sant-Peterburg, pp.24 - 25 (in Russian).
Belookaya T. V. 1993. Dynamics of the children health status of Belarus under modern
ecological conditions. “The Chernobyl catastrophe: diagnostics and medicalpsychological rehabilitation of the suffers. Collection of Conf. Materials , Minsk,
pp. 3-10 (in Russian).
Bezdrobna L., Tsyaganok T., Romanova O., Tarasenko L., Tryshyn V., Klimkina L. 2002.
Chromosomal Aberrations in Blood Lymphocytes of the Residents of 30-km
Chernobyl NPP Exclusion Zone. In: Imanaka T. (Ed.). Recent Research Activities
about the Chernobyl NPP Accadent in Belarus, Ukraine and Russia. Kyoto Univ.
Res. Reactor Inst. (KURRI-KR-79), Kyoto, pp. 277 – 287.
Byrich Т.V., Birich Т.А., Pesaerenko D.К. 1994. Diagnostics, clinical characters and
prophylactics of the cancer’ setback at adults and children. Conf.: “The Chernobyl
catastrophe: prognosis, prophylactics, treatment and medical-psychological
rehabilitation of the suffers. Collect. of Materials, Minsk, pp. 32 – 34 (in Russian).
Byrich Т.А., Chekina А.Yu., Marchenko L.N., Ivanova V.F., Dulub L.V. 1999. Ophtalmopathology at children are inhabit of the radioactively polluted territories of
Belarus, and liquidators. Ecological Anthropology. Almanac. Minsk, Byelorussian
Committee “Chernobyl Children”, pp. 183 – 184 (in Russian).
Byrjukova L.V., Тulupova М.I. 1994. Dynamics of the endocrine pathologies in Gomel
area, 1995—1993. Materials Int. Sci. Symp. «Меdical aspects of the radioactive
impact on population in the Chernobyl polluted territories», Gomel, p. 29 (in
Russian).
Bochkov N.P. 1993. Analytical review of cytogenetic studies after Chernobyl accident.
Russ. Med. Acad. Herald, # 6, cc. 51-56 (in Russian).
Bochkov N.P, Chebotarev A.N.,.Katosova L.D, Platonova V.I.. 2001. Data base for
quantitative characteristics of chromosomal aberrations frequency in human
peripheral blood lymphocytes assay. Genetic, vol. 37, N 4, pp. 549 - 557 (in
Russian).
Bogdanovich I.P. 1997. Comparative analysis of children (0-5 years) mortality in 1994 in
the radioactively polluted and clean areas of Belarus. Medical;-biolog. Effects and
ways to overcomes the consequences of the Chernobyl accident. Collection of sci.
36
ECRR 2006: CHERNOBYL 20 YEARS AFTER
papers devoted by 10th anniversary of Chernobyl accident, Minsk –Vitebsk, p. 4
(in Russian).
Bozhko А.V. 2004. Remote results of long-time impact of low ionizing irradiation on
lymphoid structures of children pharynx. Otolaryngology Herald , № 4, pp. 9-10
(in Russian).
Bortkevich L.G., Konoplya E.F., Rozhkova Z.А. 1996. Immunotropic effects of the
Chernobyl catastrophe. Conf. “10 years after the Chernobyl catastrophe: Scientific
problems”, Abstracts, Minsk p. 40 (in Russian).
Borschevsky V.V., Kalechitc О.М., Bogomazova А.V. 1996. Tendencies in the
tuberculosis morbidity after the Chernobyl catastrophe in Belarus. Med.-biol.
aspects of the Chernobyl accident, № 1, pp. 33-37 (in Russian).
Bugaev V.N., Lagutin А.Yu., Druzhynyna Е.S. 1993. Sensor’s speech infringements and
vegeto-distonia at 4-5 years old children living in Kiev. Social-psychological and
psycho-neurological aspects of the Chernobyl accidents consequences. Materials
of the scientific Conf. of the CIS states with international participation. Kiev, p.
229 (in Russian).
Bugaev V.N., Pyatak О.А., Lagutin А.G., Shul’zhenko V.B. 1995. Psychical health of the
irradiated Ukrainian children. Materials Inter. Conf. “Actual and prognostic
infringements of psychic health after nuclear catastrophe in Chernobyl”, 24 – 28
May, 1995, Ukraine, Kiev., p.18 (in Russian).
Chuprykov A.P., Chupykova Е.G., Danylov V.M., Myljuta Е.L. 1996. Phenomenon of
paroxysmal braking at children after the Chernobyl accident. Arch. Psych., № 10 –
11, pp. 53 - 54 (in Ukraine).
Danil’chik V.S., Ustynovich А.К., Vasylevsky I.V. 1996. Hormonal- biochemical
homeostasis at the newborns in the radioactively polluted areas. Public Health, №
5, pp. 17-19 (in Russian).
Demedchik Е.P., Demedchik Yu.Е., Rebeko V. Ya. 1994. Thyroid’ cancer in children.
Materials Inter. Sci. Sympos. «Medical aspects radioactive impact on population
in the Chernobyl polluted areas». Gomel, pp. 43—44 (in Russian).
Dubovaya N.I. 2005. Comparative analysis of allergosis’ distribution among green-houses
workers of Bryansk area. MaterilasInter. Sci.-pract. Conf. «Chernobyl – 20 years
after. Social-Economical Problems and persective for development of suffering
territories», Braynsk, p. 156 (in Russian).
Dubrova Y.E., Nesterov V.N., Krouchinsky N.G., Ostapenko V.A., Neumann R., Neil D.L.,
Jeffreys A.J. 1996. Human minisatellite mutation rate after the Chernobyl
accident. Nature, vol. 380, April 15, pp. 683-686.
Dubrova Y.E., Nesterov V.N., Krouchinsky N.G., Ostapenko V.A., Vergnaud G.,
Giraudeau F., Buard J., Jeffreys A.J. 1997. Further evidence for elevated human
minisatellite mutation rate in Belarus eight years after the Chernobyl accident.
Mutat. Res., Vol. 381, pp. 267-278.
Dubrova Y.E., Grant G., Chumak A.A., Stezhka V.A., Karakasian A.N. 2002. Elevated
Minisatellite Mutation Rate in the Post-Chernobyl Families from Ukraine. Am. J.
Hum. Genet., vol. 71, pp. 800- 809.
Dubrova, Y.E. and Plumb, M.A. 2002. Ionising radiation and mutation induction at mouse
minisatellite loci: The story of the two generations. Mutat. Res.,# 499, pp.143–
150.
Duda V.I., Kharkevich О.N. 1996. Endocrine mechanisms of adaptations in the dynamics
of gestation process at women under chronic radiation stress. «Motherhood and
childhoods protection under impact of consequences of the Chernobyl
37
ECRR 2006: CHERNOBYL 20 YEARS AFTER
catastrophe». Materials of scientific investigations, 1991-1995. Minsk, part. 1, pp.
96 – 99 (in Russian).
Dudynskaya R.А., Surina N.V. 2001. Condition of the thyroid system of родильниц, from
the radionuclides’ pollution in Gomel area. 3rd Iner. Conf. “ Medical
consequencies of the Chernobyl catastrophe: Results of 15-years investigations. 48 June 2001 , Kiev, Ukraine”. Abstarcts, pp. 192 -193 (in Russian).
Dzykovich I.B., Коrnilova Т.I., Kот Т.I., Vanilovich I.А. 1996. Health condition of the
pregnant and newborns from different areas of Belarus. Medical-Biological
aspects the Chernobyl accident. № 1, pp. 16 – 23 (in Russian).
Dzikovich I.V. 1996. Epidemiological analysis of ecologically dependent perinatal illnesses
in Belarus. Sci. Congr.: “10 years after the Chernobyl catastrophe (scientific
aspects of problem)” , Abstracts, Minsk, p. 87 (in Russian).
Edwards R. 1995. Will it get any worse? New Sci. Dec. 9. рр. 14 — 15.
Ermolyna L.А., Sosyukalo О.D., Suchotina N.К. 1994. Low doses impact on neuropsychical health of children (methods and preliminary results). Part 1. Social and
Clinical Psychiatry, vol 4, # 1, pp. 37 - 43 (in Russian).
Ermolyna L.А., Suchotina N.К. 1995. Comparative analysis of the neuro-psychical
pathologies of group of children, irradiated in utero and in postnatal period.
Materials Inter. Conf. “Actual and prognostic infringements of psychic health after
nuclear catastrophe in Chernobyl. 24 – 28 May 1995. Kiev, Ukraine”, Kiev, p. 310
(in Russian).
Еvetz L.V., Lyalykov S.А., Ruksha Т.V. 1993. Characters of immune infringements at
children in connection of spectrum of the isotopic pollution of territory. Conf.
“Chernobyl catastrophe: diagnostics and medical-psychological rehabilitation of
suffers”. Collection of Materials. Minsk, pp. 83 – 85 (in Russian).
Gaiduk F.М., Igumnov S.А., Shal’kevich V.B. 1994. Complex estimation of the psychical
development of children suffering from radionuclides after the Chernobyl
catastrophe. Social and clinical psychiatry, vol. 4, № 1, pp.. 44 – 99 (in Russian).
Gаpanovich V.М., Shuvaeva L.P., Vinokurova G.G., Shapovalyuk N.К., Yaroshevich R.F.,
Mel’chakova N.M. 2001. Impact of the Chernobyl catastrophe to blood’
depressions at Belarusian children. 3rd Iner. Conf. “Medical consequencies of the
Chernobyl catastrophe:results of 15-years investigations. 4-8 June, 2001, Kiev,
Ukraine”, Abstracts, pp. 175 -176 (in Russian).
Godlevsky I., Nasvit O. 1999. Dynamics of Health Status of Residents in the Lugyny
District after the Accident at the ChNPS. In: Imanaka T. (Ed.) Recent Research
Activities about the Chernobyl NPP Accident in Belarus, Ukraine and Russia.
Kioto Univ. Res. Reactor Inst. (KURRI-KR-79, pp. 149 – 157.
Golovko O.V., Izhevsky P.V. 1996. Studies of the reproductive behaviour in Russian and
Belorussian populations, under impact of the Chernobyl ionizing irradiation. Rad.
Biol., Radioecol., vol. 36, # 1, pp. 3 – 8 (in Russian).
Golubchikov М.V., Мichnenko Yu.А., Babynets А.Т. 2002. Changes in the Ukrainian
public health at post-Chernobyl period. 5 Annual Sci.-Pract. Conf.: "To XXI
Century - with safety nuclear technologies", Slavutich, 12-14 January, 2001”.
Scientific and Technological Aspects of Chernobyl, № 4, pp. 579 – 581 (in
Ukrainian).
Goncharik I.I. 1992. Arterial hypertension at inhabitant’s Near-to-Chernobyl zone.
Belarusian Public Health, № 6, pp. 10 – 12 (in Russian).
Goncharova R.I. 2000. Remote consequences of the Chernobyl Disaster: Assesnment After
13 Years. In: E.B. Burlakova (Ed.). Low Doses Radiation: Are they Dangerous?
NOVA Sci. Publ., pp. 289 – 314.
38
ECRR 2006: CHERNOBYL 20 YEARS AFTER
GorptchenkoI.I., Ivanyuta L.I., Sol’sky Ya.P. 1995. Genital System. In: Baryachtar V. G.
В.Г.(Ed.). Chernobyl Catastrophe. Kiev, «Naukova Dumka» Publ., pp. 471 – 473
(in Russian).
Goffman J. 1994а. Chernobyl accident: radioactive consequences for the existing and the
future generations. Minsk, «Vysheihsaya Shkola» Publ., 576 p. (in Russian).
Goffman J. 1994b. Radiation-Induced Cancer from Low-Dose Exposure: an Independent
Analysis. Translation from English Edition (1990). Social Ecological Union Publ.,
Moscow, vol. 1,2, 469 p. (in Russian).
Grodzinsky D.M. 1999. General situation of the Radiological Consequences of the
Chernobyl Accident in Ukraine. In: Imanaka T. (Ed.) Recent Research Activities
about the Chernobyl NPP Accadent in Belarus, Ukraine and Russia. Kyoto Univ.
Res. Reactor Inst. (KURRI-KR-7), pp. 18 – 28.
Gudkovskyi I.А., Kul’kova L.V., Blet’ko Т.V., Nechai Е.V. 1995. Children health and
level of Cs-137 pollution in the invalitated territories. Intern, Sci. Conf. Devoted
5th anniversary of Gomel State Med. Inst., 9 - 10 November 1995, Гомель,
Belarus”, Materials, Gomel, pp. 12 – 13 (in Russian).
Gurmanchuk I.Е., Tythov L.P., Kharytonik G.D., Kozlova N.А. 1995. Comparative
characteristics of immune status of the sick children in Gomel’, Mogilyov’ and
Brest’ areas. Actual problems of immunology and allergology. 3rd Congress
Beloru. Sci. Society of Immunologists and Allergologists. Abstracts. Grodno, pp.
79 – 80 (in Russian).
Health Consequences of the Chernobyl Accident. 1995. Results of the IPHECA Pilot
Projects and Related National Programmes. Scientifical Report of the International
Programme on the Health Effects of the Chernobyl Accident. WHO. Geneva, 560
Ibragimova A.I. 2003. Clinical data on genotoxic action of ionizing radiation. Russ. Herald
Perinatol., Pediatr., vol. 48, № 6, pp. 51 – 55 (in Russian).
Ivanenko G.F., Suskov I.I., Burlakova Е.B. 2004. Glutathione level and cytogenetic
characters in peripheral lymphocytes at children under low dose impact. Herald of
Russ. Acad. Sci., Seria Biologia, № 4, pp. 410 – 415 (in Russian).
Ignatov V.А., Selyvestrova О.Yu., Tsurykov I.F. 2001. Eho 15th post-Chernobyl years in
Kaluga land. “Legacy of Chernobyl”. Materials Sci.-Pract. Conf. "Medicalpsychological , radio ecological and social-economical consequences of the
Chernobyl accident in Kaluga area". Kaluga, Obninsk, # 3, pp. 6 – 15 (in
Russian).
Igumnov S.A., Sekatch N.S., Chuiko Z.А. 1993. Complex diagnostics of psychic
development of children after of radioactive impact during critical period of
cerebrogenesis. Conf.: “Chernobyl catastrophe: diagnostics and medicalpsychological rehabilitation of the suffers”. Collection of materials, Minsk, pp. 14
— 15 (in Russian).
Imanaka T. (Ed.) 2002. Recent Research Activities about the Chernobyl NPP Accident in
Belarus, Ukraine and Russia, Kyoto Univ. Res. Reactor Inst. (KURRI-KR-79),
Kyoto, 297 p.
Iskrytskyi А.М. 1995. Humoral immunity and immunological characters of human milk in
the radioactively polluted areas of Belarus. «Actual problems of immunology and
allergology», III Congress Belorus. Sci. Soc. Immunologists and Allergologists.
Abstracts, Grodno, pp. 85 – 86 (in Russian).
Ivanov V.К., Matveenko Е.G., Byryukov А.P. 1996. Analysis of new registered illnesses
at Kaluga area’s liquidators. «Legacy of Chernobyl», Materials Sci.-Pract. Conf.
"Medical-psychological , radio ecological and social-economical consequences of
39
ECRR 2006: CHERNOBYL 20 YEARS AFTER
the Chernobyl accident in Kaluga area". Kaluga, Obninsk, # 2, pp. 233-234 (in
Russian).
Ivanov V.K., Tsyb A.F., Nilova E.V. 1997. Cancer risks in the Kalyga oblast of the Russian
Federation 10 years after the Chernobyl accident. Radiat. Environ. Biophys. Vol.
36, pp. 161-167.
Kapustina N.К. 2005. Dinamics of Congenital malformations in Bryansk area, 1999 - 2004.
Materials Inter. Sci.-Pract. Conf.: «Chernobyl - 20 years after. Social-economical
problems and perspective for development of the impacted territories», Bryansk,
pp. 163 – 164 (in Russian).
Кapytonova E.К., Кryvitskaya L.V. 1994. Babies morbidity structure on the radioactively
polluted territories in 6 years after Chernobyl accident. Materials Inter. Sci. Symp.
«Medical Aspects of radioactive impact on populations after the Chernobyl
accident», Gomel, p .52 (in Russian).
Karevskaya I.V., Кurbatskaya G.Ya., Vasil’tsova О.А., Stepunin L.А., Zubareva I.А. 2005.
Dispanserization’ role in the diagnostics of thyroids deceases at population of
South-Western districts of Bryansk area. Inter. Sci.-Pract. Conf.: «Chernobyl - 20
years after. Social-economical problems and perspective for development of the
impacted territories», Bryansk, Materials, pp. 164 – 165 (in Russian).
Kashirina М.А. 2005. Social-ecological factors of public health in the radioactively
polluted territories of Bryansk area. Inter. Sci.-Pract. Conf.: «Chernobyl - 20 years
after. Social-economical problems and perspective for development of the
impacted territories», Bryansk, Materials, pp. 166 – 167 (in Russian).
Kharytonik G.D., Tytov L.P., Gurmanchuk I.Е., Ignatenko S.I. 1996. Character and
dynamics immunological characters at children living during seven years in the
condition “clean” territories of Bragin district. Sci. – Pract. Conf. “Remote
consequences of irradiation for immune and haemopoetic systems. 7 - 10 October
1996, Kiev, Ukraine”, Abstracts, Kiev, pp. 59 – 60 ( In Ukranian).
Khomich G.Е., Lysenko Yu.V. 2002. Blood vessels’ reographic characters of legs after
change of spase position at girls with increasing vessel tonus and living in the
radioactively polluted zone. Brest State Univ., Brest, 6 p. (in Russian).
Khmara I.M., Astakhova L.N., Leonova L.L. et al. 1993. Indices of immunity in children
suffering with autoimmune thyroiditis. J. Immunol. № 2, pp. 56-58.
Kienya А.I., Еrmolitskyi N.М. 1997. Vegetative component of child organism’ activity
with different level of incorporated Cs-137. In: Bandajevsky Yu.I. (Ed.) Structural
and functional effects of incorporated radionuclides, Gomel, pp. 61 – 82 (in
Russian).
Коlominsky Ya.L., Igumnov S.А. 1994. Social-psychological factors impact on psychical
development of children 6-7 years old, from the Chernobyl territories. Inter. Conf.
“Social-psychological rehabilitation of people suffering from ecological and
thechnogenic catastrophes” Abstractes, Gomel, p. 33 (in Russian).
Kolominsky Y., Igumonov S., Drozdovitch V. 1999. The psychological development of
children from Belarus exposed in the prenatal period to radiation from the
Chernobyl atomic power plant. J. Child Psychol., Psychiat. Vol. 40, № 2, pp. 299305.
Комоgortseva L.К. 2001. Report for Bryansk Duma . prepared by representative L. K.
Komogortseva on base on data from Bryansk Committee of Public Health and
Bryansk Statistical Bureau. 31 января 2001 г., MS, 4 p. (in Russian).
Korsakov А.V. 2005. Comparisons of circulatory and neurological reactions of children
from the ecologicvally, radioactively and toxically unsafe territories. Inter. Sci.Pract. Conf.: «Chernobyl - 20 years after. Social-economical problems and
40
ECRR 2006: CHERNOBYL 20 YEARS AFTER
perspective for development of the impacted territories», Bryansk, Materials, pp.
171- 173 (in Russian).
Krapyvin N.N. 1997. Chernobyl in Lypetsk: yesterday, today and tomorrow … Lypetsk,
36 p. (in Russian).
Kul’kova L.V., Ispenkov Е.А., Gutkovsky I.А., Voinov I.N., Ulanovcskaya Е.V.,
Skidanenko G.I., Maevsky G.А., Yunhel’ V.V. 1996. Epidemiological monitoring
children health on the radionuclides’ polluted territories of Gomel area. Med.
Radiol. And Radioact. Safety, № 2, pp. 12 – 15 (in Russian).
Kulakov V.I., Sokur A.L., Volobuev A.L. et al. 1993. Female reproductive funсtions in
areas affected by radiation after the Chernobyl power station accident. Environ.
Health Perspect. Suppl., Vol. 101.
Kyra Е.F., Tsvelev Yu.V., Greben’kov S.V., Gubin V.А., Chernichenko I.I. 2003. Woman
reproductive health in the radioactively polluted territories. Military-Medical J.,
vol. 324, № 4, pp. 13 – 16 (in Russian).
Kyril’chek Е.Yu. 2000. Characters of immune status and immune-rehabilitation of children
on the radionuclides’ polluted territories (clinic-laboratory investigation, 19961999). Thesis, Dr. Med., Minsk State Med. Inst., Minsk, 21 p. (in Russian).
Lаvdovskaya М.V., Lysenko А.Ya., Basova Е.N., Lozovaya G.А., Baleva L.S., Rybalkyna
Т.N. 1996. Ionizing radiation’ impact on the distribution of cryptosporidiosis and
pneumocystosis. Phraseology, № 2, pp. 153 – 157 (in Russian).
Lazjuk G.I., Kirillova I.А., Nikolaev D.L. 1994. Dynamics of congenital pathologies in
Belarus and the Chernobyl catastrophe. Conf.: Chernobyl catastrophe: diagnostics
and medical-psychological rehabilitation of the suffers”. Collection of materials,
Minsk, pp. 167 - 183 (in Russian).
Lazjuk G.I., Nikolaev D.L., Novikova I.V. 1997. Changes in registred congenital anomalies
in the Republic of Belarus after the Cghernobyl accident. Stem Cells, 15, Suppl. 2,
pp. 255 – 260.
Lazjuk G.I., Nikolaev D.L., Novikova I.V., Polityco A.D., Khmel R.D. 1999. Belarusian
population radiation exposure after Chernobyl accident and congenital
malformations dynamics. Int. J. Rad. Med. # 1, pp. 63-70.
Lazjuk G., Satow Y., Nikolaev D., Novikova I. 1999. Genetic Consequences of the
Chernobyl Accident for Belarus Republic. In: Imanaka T. (Ed.) Recent Research
Activities about the Chernobyl NPP Accident in Belarus, Ukraine and Russia.
Kyoto Univ. Res. Reactor Inst. (KURRI-KR-7), pp. 174 - 177.
Lazjuk G.I., Naumchik I.V., Rumyantseva N.V., Polytyko А.D., Khmel’ R.D., Egorova
Т.М., Kravchuk Zh.P., Verje P., Robert V., Satov Yu. 2001. Main results of
studied of genetical consequences of the Chernobyl catastrophe at Belarus
population. 3rd Inern. Conf. “ Medical consequences the Chernobyl catastrophe:
results of 15-years investigations. 4-8 June 2001, Kiev, Ukraine”. Abstarcts, pp.
221 – 222 (in Russian).
Lazjuk G.I., Zatsepin I.О., Verje P., Ganier B., Robert Е., Kravchuk Zh.P., Khmel’ R.D.
2002. Down’ Syndrom and ionizing radiation: reason-effect or bychance
connetions. Rad. Biol., Radioecol., vol. 42, № 6, pp. 678 – 683 (in Russian).
Leonova Т.А., Astakhova L.N. 1998. Autoimmune thyroiditis at pubertal girls. Public
Health. № 5, pp. 30 – 33 (in Russian).
Ljaginskaja A.M., Osipov V.A. 1995. Comparison of estimation of reproductive health of
population from contaminated territories of Bryansk and Ryazan areas of the
Russian Federation. In: “Radioecological, Medical and Socio-economical
Consequences of the Chernobyl Accident. Rehabilitation of Territories and
Populations”, Moscow. Abstracts, p. 91 (in Russian)..
41
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Ljaginskaja A.M., Izhewskij P.V., Golovko O.V., 1996. The estimate reproductive health
status of population exposed in low doses in result of Chernobyl disaster,. In:
IRPA 9. Proceedings of the International Congress on Radiation Protection,
Volume 2. pp. 62 – 67.
Ljaginskaja A.M., Golovko O.V, Osipov V.A. et al. 1997. Criteria for estimation of early
deterministic effects in exposed populations, In: Third Congress of Radiation
Research, Moscow. pp. 73-74 (in Russian).
Lialykov S.А., Evets Е.V., Makarchik А.V. 1993. Peculiarity of the endocrine status of the
children after long-time low doses irradiation. Conf.: “Chernobyl catastrophe:
diagnostics and medical-psychological rehabilitation of suffers”. Collection of
Materials, Minsk, pp.. 68 — 70 (in Russian).
Lipnik В. 2004. The Earth and Radiation: realyty terrifyer than numbers..
(http://www.pravda.ru/science/planet/environment/47214-0)
Lisianyi N.I., Ljubich L.D. 2001. Role of the neuro-immune reactions for development of
the post-radiation encephalopathy after low dose impact. 3rd Inter. Conf. “Medical
consequences of the Chernobyl catastrophe: results of 15-years investigations, 4-8
июня 2001, Kiev, Ukraine.” Abstracts, Kiev, p. 225 (in Russian).
Loganovsky K.N. 1998. Schizophrenic characters at persons after ionizing irradiation as
result of the Chernobyl catastrophe. 2nd Inter. Conf. “ Remote medical
consequences of the Chernobyl catastrophe, 1– 6 June 1998, Kiev, Ukraine”, Kiev,
Abstracts, p. 78 (in Russian).
Loganovsky K.N. 1999. Clinic- epidemiological aspects psychiatric consequences of the
Chernobyl catastrophe. Social and clinical psychiatry, vol. 9, # 1, pp. 5 – 17 (in
Russian).
Loganovsky
K.
2005.
Health
of
children
irradiated
in
utero..
(http://stopatom.slavutich.kiev.ua/2-2-7.htm).
Loganovsky K.N., Loganovskaya T.K. 2000. Schizophrenia spectrum disorders in persons
exposed to ionizing radiation as a result of the Chernobyl accident. Schizophr.
Bull., Vol. 26, pp. 751-773.
Lomat’ L.N. Antipova S.I., Metel’skaya М.А. 1996. Ilnesses of children suffering from the
Chernobyl catastrophe, 1994. Medical-biological consequences of the Chernobyl
accident. № 1. pp. 38 – 47 (in Russian).
Lukomsky I.V., Protas R.N., Аlexeenko Yu.V. 1993. Peculiarity of the neurological
diseases of the adult population in the zone of the tight radiation control. “Impact
of radionuclides’ pollution on public health: clinical-experimental study”.
Collection of Sci. papers, Vitebsk State Med. Institute , Vitebsk, pp. 90—92 (in
Russian).
Lukianova А.G., Lenskaya R.V. 1996. Dynamics of cytological-chemical characters of
lymphocytes from the peripheral blood at Chernobyl children, 1987 -1995.
Hematology and Transfusiology. vol. 41, № 6, pp. 27 – 30 (in Russian).
Malko M.V. 2002. Chernobyl Radiation-induced Thyroid Cancers in Belarus. In: Imanaka
T. (Ed.). Recent Research Acticities about the Chernobyl NPP Accident in
Belarus, Ukraine and Russia. Kioto Univ. Res. Reactor Inst. (KURRI-KR-79),
Kyoto, pp. 240- 256.
Malko M.V. 2004. Radiogenic thyroid cancer in Belarus as consequences of the Chernobyl
accident. In: Med.-biol. Problems radio- and chemical protection. Collect. of
Papers Russ. Sci. conf., Sank-Petersburg, 20 – 21 May, 2004. pp. 113-114 (in
Russian).
42
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Manak N.А., Rusetskaya V.G., Lazjuk D.G. 1996. Analysis of blood circulatory illnesses of
Belarus population .Medical-biological aspects of the Chernobyl accident. № 1,
pp. 24 – 29 (in Russian).
Marples D.R. 1996. The decade of despair. Bull. Atomic Sci., May/June, pp.22—31.
Matveev V.А., Voropaev Е.V., Кolomiets N.D. 1995. Role of the herpes virus infections in
the infant mortality of Gomel territories with different density of radionuclides
pollution. Actual problems of immunology and allergology. III Congress Belarus.
Sci. Soc. Immun., Allergol. Grodno, Abstracts, p. 90 (in Russian).
Maznik N.А., Vinnikov V.А. 2002. Level of chromosomal aberrations in peripheral blood
lymphocytes at evacuees and living in the radioactively polluted territories after
the Chernobyl accident. Rad. Biol., Radioecol., vol. 42, № 6, pp. 704 – 710 (in
Russian).
Mel’nichenko E.М., Cheshko N.N. 1997. Condition of children tooth and stomathological
support in the regions of radioactive pollution. Public Health, № 5, pp. 38 – 40 (in
Russian).
Mel’nov S.B., Senerichina S.Е., Savitsky V.P., Dudarenko О.I. 1999. Medical- genetical
aspects of the thyroid cancer at children after the Chernobyl accident. In:
Ecological Anthropology. Almanac. Minsk, Belarus Committee “Chernobyl
Children” , pp. 293 – 297 (in Russian).
Mezhzherin V.А. 1996. Civilization and Noosphera. Book 1. Kiev, 144 p. (in Russain).
Miksha Ya.S,, Danylov I.P. 1997. Consequences of the chronic impact by ionizing
irradiation on the haemopoiesis in Gomel area. Public Health, № 4. pp. 19 – 20
(in Russian).
Morozevich Т.S., Gres’ N.А., Arynchyn А.N., Petrova V.S. 1997. Some eco-pathogenic
problems of disturbances of the hair growth at Byelorussian children. Actual
problems of medical rehabilitation of population suffering from the Chernobyl
catastrophe. Materials Sci.- Pract. Conf. devoted by 10 anniversary Republic
Radiation medicine dispenser, 30 June 1997, Minsk. Pp. 38 – 39 (in Russian).
Moskalenko В. 2003. Estimation of consequences of the Chernobyl catastrophe for
Ukrainian public health. The World Ecological Herald, vol. XIV, № 3 - 4, pp. 4 –
7 (in Russian).
Nagornaya А.М. 1995. Adult population health of Zhytomir area, which suffer from
radioactive impact after the Chernobyl accident and living in the strict control
radiation zone (by National register data). «Public health problems and
perspectives of Zhytomir area», Materials Sci.- Pract. Conf. devoted 100-years
anniversary O.F. Gerbachevsky’ hospital, Zhytomir, 14 September, 1995”,
Zhytomir, pp. 58 – 60 (in Ukrainian).
Nedvechkaya V.V., Lialykov S.А. 1994. Cardio-interval-graphical investigation of the
nervous system at children from the radioactively polluted territories. Belarusian
Public Health, № 2, pp. 30 – 33 (in Russian).
Nesterenko V.B., Yakovlev V.А., Nazarov А.G. (Eds.). 1993. Chernobyl catastrophe.
Reasons and consequencies (Expert conclusion). Part 4. Consequences for Ukraine
and Russia. Minsk, “Test” Publ., 243 p. (in Russian).
Nesterenko V.B. 1996. Scale and consequences of the Chernobyl catastrophe for Belarus,
Ukraine and Rassia. Minsk, «The Right and Economics» Publ., 72 p.(in Russian).
Nyagu А.I. 1995. Nervous system. In: Barhyar V.G. . (Ed.). Chernobyl catastrophe. Kiev,
"Naukova Dumka" Publ., pp. 458 - 459 (in Russian).
Nyagu А.I., Loganovsky K.N. 1998. Neuro-psychiatric effects of ionizing irradiation. Kiev,
Scientific Center of Radiation Medicine Ukrainian Academy of Medical Science,
370 p. (in Russian).
43
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Nyagu A.I., Loganovsky K.N., Loganovskaya T.K., Repin V.S., Nechaev S.Yu. 2002.
Intelligence and Brain Damage in Children Acutely Irradiated in Utero As a Result
of the Chernobyl Accident. In: Imanaka T. (Ed.). Recent Research Activities about
the Chernobyl NPP Accident in Belarus, Ukraine and Russia. Kyoto Univ. Res.
Reactor Inst. (KURRI-KR-79), Kyoto, pp. 202 – 231.
Okeanov A. E., Yakimovich G. V., Zolotko N. I., Kulinkina V. V. 1996. Dynamics of
malignant neoplasms incidence in Belarus, 1974-1995. Biomedical aspects of
Chernobyl NPP accident. No. 1, pp. 4 - 14 (in Russian).
Okeanov N.N., Yakimovich A.V. 1999. Incidence of malignant neoplasms in population of
Gomel Region following the Chernobyl accident. Int. J. of Radiat. Medicine, vol.
1, No 1, pp. 49 –54 (cit. by R.I. Goncharova, 2000).
Okeanov A.E., Sosnovskaya E.Y., Priatkina O.P. 2004. A national center registry to asses
trends after the Chernobyl accident. Swiss Med. Weekly, # 134, pp. 645 – 649.
Omelianetz N.I., Kartashova S.S., Dubovaya N.F., Savchenko А.B. 2001. Cancer mortality
and its impact on life expectancy in the radioactively polluted territories of
Ukraine. 3rd Inter. Conf. “Medical consequences of the Chernobyl catastrophe:
results of the 15-years investigations. 4 - 8 June 2001, Kiev, Ukraine”. Abstracts,
Kiev, pp. 254 – 255 (in Russian).
Omelianetz N.I., Klement’eva A.А. 2001. Mortality and longevity analysis of Ukrainian
population after the Chernobyl catastrophe. 3rd Inter. Conf. “Medical
consequences of the Chernobyl catastrophe: results of the 15-years investigations.
4 - 8 June 2001, Kiev, Ukraine”. Abstracts, Kiev, pp. 255 – 256 (in Russian).
Orlov Yu.А. 1993. Dynamics of congenital malformations and primitive neuro-ectodermal
tumors. Social-psychological and psycho-neurological consequences of the
Chernobyl catastrophe. Materials Sci. Conf. CIS states with inter. Participation,
Kiev, pp. 259 -260 (in Russian).
Orlov Yu.А. 1995. Neuro-surgery pathologies’ structure at children in post-Chernobyl
period. Materials Inter, Sci. Conf. “Actual and prognostic infringements of psychic
health after the nuclear catastrophe in Chernobyl, 24 -28 May, 1995. Kiev,
Ukraine”, Kiev, "Chernobyl Doctors" Assoc., p. 298 (in Russian).
Orlov Yu.А., Verchogliadova T.L., Plavsky N.V., Malysheva Т.А., Shaversky А.V.,
Guslitzer L.N. 2001. CNS tumors at children (Ukrainian morbidity for 25 years).
3rd Inter. Conf. “Medical consequences of the Chernobyl catastrophe: results of
the 15-years investigations. 4 - 8 June 2001, Kiev, Ukraine”. Abstracts, Kiev, pp.
258 (in Russian).
Paramey V.Т., Saley М.Ya., Madekin А.S., Otlivanchik I.А. 1993. Lens condition at people
living in the radionuclides polluted territories.
Pasechnik L.I., Chuprykov А.G. 1993. Impact of radiation factor into formation of the
children’ neuro-psychical sphere. In: “Chernobyl catastrophe: diagnostics and
medical-psychological rehabilitation of suffers”, Collection of Conf. Materials,
Minsk, pp. 15—16 (in Russian).
Paramonova N.S., Nedvetskaya V.V. 1993. Physical and sexual development indices of
children under long-term impact of low doses irradiation. In: “Chernobyl
catastrophe: diagnostics and medical-psychological rehabilitation of suffers”,
Collection of Conf. Materials, Minsk, pp. 62—64 (in Russian).
Pelevina I.I., Аfanasiev G.G., Gotlib V.Ya., Serebryanyi A.М. 1996. Cytogenetical changes
in peripheral blood at people living in the Chernobyl polluted areas. In: E.B.
Burlakova (Ed.). Consequencies of the Chernobyl catastrophe. Public health.
Moscow, Center for Russian Ecological Policy, pp. 229 – 244 (in Russian).
44
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Petrenko S.V., Zaitzev V.А., Balakleevskaya V.G. 1993. Hypóphysis- adrenal system at
children living in the radionuclides’ polluted territories. Belarusian Public Health,
№ 11, pp. 7 - 9 (in Russian).
Petrova А.М., Maistrova I.N., Zafranskaya М.М. 1993. Infant’ immune system in the
territories with different levels of Cs-137 soil pollution. In: “Chernobyl
catastrophe: diagnostics and medical-psychological rehabilitation of suffers”,
Collection of Conf. Materials, Minsk, pp. 74—76 (in Russian).
Pilinska М.А. 1999. Cytogenetic effects in somatic sells of people have suffered from the
Chernobyl catastrophe as biomarkers of the low dose ionizing radiation impact.
Inter. J. Rad. Med. , № 2, pp. 60 – 66 (in Russian).
Pilinska М.А., Dyb’skyi S.S., Dyb’ska О.B., Pedan L.R. 2003. Somatic chromosomal
mutagenesis at children living in the radionuclides’ polluted territories of Ukraine
during post-Chernobyl period. Report Nat. Sci. Acad. Ukraine, № 7, pp. 176 – 182
(in Ukrainian).
Podpalov V.P. 1994. Formation hypertonic disease in population of the radioactively unsafe
territories. In: “Chernobyl catastrophe: diagnostics and medical-psychological
rehabilitation of suffers”, Collection of Conf. Materials, Minsk, pp. 27—28 (in
Russian).
Polonetskaya S.N., Chakolva N.N., Demedchik Yu.Е., Michalevich L.S.
2001.
Cytogenetical analysis of the normal and tumor thyroid gland cells in vivo. 4th
Congress on Radiation Researches. Rad. Biol. Radioecol., Rad. Safety. Moscow,
20 – 24 November 2001, Abstracts, vol.1, p. 257 (in Russian).
Prilipko L.L., Nyagu А.I., Kozlova I.А., Gaiduk F.М., Loganovsky К.N., Podcorytov V.S.,
Plachinda Yu.I., Antipchuk Е.Yu. 1995. Scientific resultes of researches on pilot
project progrmme IFECA «in utero brain’ infringements». Materials Inter. Sci.
Conf. “Actual and prognostic infringements of psychic health after the nuclear
catastrophe in Chernobyl, 24 -28 May, 1995. Kiev, Ukraine”, Kiev, "Chernobyl
Doctors" Assoc., p. 316 (in Russian).
Prokopenko N.A. 2003. Cardio-vascular and nervous systems pathologies as synergic result
of the irradiation and psycho-emotional stress at sufferings from the Chernobyl
accident. Aging and longevity problems. vol. 12, № 2, pp. 213 – 218 (in Russian).
Prysyazhnyuk A.Ye., Grishtshenko V.G., Fedorenko Z.P., Gulak L.O., Fuzik M.M. 2002.
Review of Epidemiological Finding in Study of Medical Consequences of the
Chernobyl Accident in Ukrainian Population In: Imanaka T. (Ed.). Recent
Research Activities about the Chernobyl NPP Accadent in Belarus, Ukraine and
Russia. Kyoto Univ. Res. Reactor Inst. (KURRI-KR-79), Kyoto, pp. 188 – 287.
Pshenichnikov B.V. 1996. Low doses radioactive irradiation and radiation sclerosis. Kiev,
«Soborna Ukraina» Publ., 40 p. (in Russian).
Pysarenko S.S. 2003. On man sterility in XX Century. Herald New Med. Technology.,
vol. 10, № 3, pp. 106 – 107 (in Russian).
Romanenko A., Lee C., Yamamoto S. et al. 1999. Urinary bladder lesions after the
Chernobyl accident: immune-histochemical assessment of proliferating cell
nuclear antigen, cyclin D1 and P 21 waf1/Cip. Japan J. Cancer Res., vol. 90, pp.
144 - 153.
Rudnytzkyi Е.А., Sobolev А.V., Kiseleva L.F. 2003. People illnesses by microsporidias in
the radionuclides’ zone. Problems Med. Micol., vol. 5, № 2, pp. 68 (in Russian).
Sevan’kaev А.V., Zhloba А.А., Potetnya О.I., Anykyna М.А., Moiseenko V.V. 1995.
Cytogenetic observations at children and adolescens living in the radionuclides
polluted territories of Bryansk area. Rad. Biol., Radioecol., vol 35, # 5, pp. 596 –
611 (in Russian).
45
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Sevbitov А.V., Pankratiova N.V., Slabkovskaya А.B., Scatova Е.А. 1999. Tooth – jaw’
anomalies at children after impact of the “Chernobyl factor”. Ecological
anthropology. Almanac. Minsk, Belarusian committee «Chernobyl children», pp.
188 -191 (in Russian).
Sevbitov А.V. 2005. Stomatological characters of the clinical manifestations of the remote
effects of irradiation. Thesis, Doc. Med. Sci., Central Stomatological Inst.,
Moscow, 51 p. (in Russian).
Sergeeva М.Е., Мuratova N.А., Bondarenko G.N. 2005. Demographic peculiarities in the
radioactively polluted zone of Bryansk area. Materials Inter. Sci. – Pract. Conf.:
«Chernobyl - 20 years after. Socio-economical problems and perspectives for
development of suffering territories», Bryansk, pp. 302 – 304 (in Russian).
Sharapov А.N. 2001. Regulations of the endocrine – neuro-vegetative’ interconnections at
children living in the low doses radionuclides pollution territories after the
Chernobyl accident. Thesis, Doc. Med., Sci. Inst.Pediat., Child. Surgery, Moscow,
53 p. (in Russian).
Shilko А.N., Taptunova А.I., Iskritzkyi А.М., Tschadystov А.G. 1993. Frequencies and
etiology sterility and невынашивания in the Chernobyl factors impacted
territories. Conf.: “Chernobyl catastrophe: diagnostics and medical-psychological
rehabilitation of suffers.”, Collection of Materials, Minsk, p. 65 (in Russian).
Sitnikov V.P., Kunitskyi V.S., Bakanova V.А. 1993. Clinical-immunological expressions
of the oto-pharynx deceases at children from the Chernobyl zone. Radionuclides
pollution impact to public health clinical-experimental study). Collection of Sci.
Papers , Vitebsk State Med. Inst., Vitebsk, pp. 127—130 (in Russian).
Sluchik V.М., Kovalchuk L.Е., Bratyvnych L.I., Shutak V.I. 2001. Cytogenetic effects of
the low dose of ionizing radiation and chemical factors (15 years after the
Chernobyl). 3rd Inter. Conf. “ Med. Consequences of the Chernobyl catastrophe:
results 15-years researches. 4 - 8 June 2001, Kiev, Ukraine”, Abstracts, Kiev, p.
290 (in Russian).
Sokolov V.V. 2003. Retrospect estimation irradiated doses at the Chernobyl radioactively
polluted territories. Thesis, Doc. Thechn. Sci. , Tula State University, Tula, 36 p.
(in Russian).
Sokolovskaya Ya. 1997. One more Chernobyl impact. Radiation Рstruck do not only heart
and blood, but brain. «Izvestia», 3 October, p.5 (in Russian).
Soloshenko EN. 2002. Immune homeostasis at the dermatitis patients, which suffers from
radioactive irradiation during the Chernobyl accident. Ukrainian J. Hematol.
Transfusiol., № 5, pp. 34 – 35 (in Ukranian).
Souchkevitch G. 1996. WHO tracks health effects. Monitor, vol. 4, №1, pp. 4—5.
Sources and effects of Ionizing radiation. 2000. UNSCEAR 2000 Report to the General
Assembly. Annex J. Exposure and effects of the Chernobyl accident. United
Nations, New York, 155 p.
Sources and effects of Ionizing radiation. 2000. UNSCEAR 2000 Report to the General
Assembly. Annex G. United Nations, New York, 130 p.
State of Health at Bryansk population suffering from the Chernobyl accident. 1999.
Collection analytical and statistical materials, 1995 - 1998. Bryansk, Department
of Public Health, Bryansk Administration (http://www.miac.brk.ru).
Stepanov А.V. 1993. Analysis of the Trichocephalisis occurrence in the radioactively
polluted territories. Radionuclides pollution’ impact in public health (clinicalexperimental study). Collection of Sci. papers, Vutebsk State Med. Inst., Vitebsk,
pp. 120 – 124 (in Russian).
46
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Stepanova Е.I., Davidenko О.А. 1995. Children haemopoetic system’ reactions on the
unhealthy Chernobyl accident’ impact. III Ukr. Congr. Hematol. Transfusiol. 2325 May, 1995, Sumy, Ukraine”, Kiev, p. 134 (in Ukrainian).
Stepanova Е.I, Misharina Zh.А., Vdovenko V.Yu. 2002. Remote cytogenetics effects at in
utero irradiated children after the Chernobyl accident. Rad. Biol., Radioecol., vol.
42, № 6, pp. 700 – 703 (in Russian).
Strukov Е.L. 2003. Hormonal regulation of the cardio-circular diseases and some endocrine
dysfunctions at persons suffering by the Chernobyl factors and in Sank-Petersburg
population. Thesis Doc. Med., All-Russian Center for Extr. Rad. Medicine, SankPetersburg, 42 p. (in Russian).
Surykov B.T. 1996. Chernobyl: 10 years the largest technological catastrophe in history.
Ecology and Life, № 1. pp. 31—36 (in Russian).
Sykorenskyi A.V., Bagel’ G.Е. 1992. Primordial arterial hypotonic at children of Gomel
and Mogiliev areas and perspectives of their improvement in the summer camps.
Improvement and sanitary treatment of persons suffering from radiation impact.
Abstracts, Republican Conf., Minsk - Gomel, pp. 59 – 60 (in Russian).
Tereschenko V.М., Geetz V.I., Perevosnikov О.N, Litvinetz L.А. 1991. Age characteristics
of the Cesium level at inhabitants of Narodychesky district of Zhytomir area.
Probl. Rad. Medicine, Kiev, pp. 99 – 103 (in Russian).
Terletzkaya R.N. 2003. Lung’ chronic deseases at children after long-time living under law
dose impact. Rus. Herald Perinatol.,Pediatry, vol. 48, № 4, pp. 22 – 28 (in
Russian).
Тron’ko N.D., Tchaban А.К., Oleinik V.А., Epstein Е.V. 1995. Endocrine system. In:
Baryachtar V.G. (Ed.). Chernobyl catastrophe. Kiev, “Naukova Dumka” Publ., pp.
454 – 456 (In Russian).
Tsybul’skaya I.S., Suhanhova L.P., Starostin В.М., Mitryukova L.B. 1992. Functional
condition of the cardio-vascular system at children early ages under the low dose
irradiation chronic impact. Motherhood and Childhood, vol. 37, № 12, pp. 12 – 20
(in Russian).
Ulyanova О.S., Mashneva N.I., Ponomarev А.V., Sukal’skaya S.Ya. 1995. Psychomotoric
development of children, with different impact in utero Chernobyl irradiation.
Inter. Conf. “Actual and prognostic infringements of psychic health after nuclear
catastrophe in Chernobyl, 24 - 28 May, 1995, Kiev, Ukraine”, Materials, Kiev,
“Chernobyl Doctors” Assoc., p. 318 (in Russian).
Utka V.G., Scorkina Е.V., СSadretdinova L.Sh. 2005. Medical-demographic dynamics in
South-Western districts of Bryansk area. Materials Inter. Sci. – Pract. Conf.
«Chernobyl – 20 years after. Socio-economical problems and perspective for
development suffering territories», Bryansk, pp. 201 – 203 (in Russian).
Ushakov I.B., Arlaschenko N.I., Dolzhanov A.Ya., Popov V.I. 1997. Chernobyl: radiation
psychophysiology and human ecology. State Sci. Inst. Avia, Space Med., Moscow,
247 p. (in Russian).
Ushakov I.B., Karpov V.N. 1997. Brain and radiation (100 anniversary of radioneurobiology). State Inst. Avia , Space Medicine , Moscow, 74 p. (in Russian).
Ushakova Т.N., Аksel’ Е.М., Bugaeva А.R., Maikova S.А., Durnoe L.А., Poliakov V.G.,
Symonov А.F. 2000. Peculiarities of the cancer tumors ilnewsses at children of
Tula area after the Chernobyl catastrophe. In: «Chernobyl: Duty and courage»,
vol. I (http://www.iss.niiit.ru/book-4/glav-2-26.htm) (in Russian).
Vasyna Т.I., Zubova Т.N., Тarasova Т.G. 2005. Some hematological characters at children,
living in the territories polluted after Chernobyl accident. Inter. Sci.- pract. Conf.
47
ECRR 2006: CHERNOBYL 20 YEARS AFTER
«Chernobyl - 20 years after. Social-economical problems and perspectives for
development of suffering territories», Bryansk, pp. 152 – 154 (in Russian).
Vaskevich А.Yu., Chernyshova V.I. 1994. Mozyr city’ children health under low intensive
radioactive pollution. Belarusian Children health in the modern ecological
conditions (Chernobyl consequences). Collection of materials, V1 pediatric
Congress of Belarus. Gomel, pp. 27 - 29 (in Russian).
Voropaev Е.V., Matveev V.А., Zhavoronok S.V., Naralenkov V.А. 1996. Activation of
Herpesvirus infection after the Chernobyl accident. Sci. conf. “10 years after the
СChernobyl catastrophe: scientific aspects”, Abstracts, Minsk, p. 65 (in Russian).
Vovk U.B., Mysurgyna О.А. 1994. Estimation radioactive pollution and doses of
irradiation from the Chernobyl accident in the Global scale. Inter. Conf. “Nuclear
Accidents and Future of Energetic. Chernobyl Lessons (Paris, France, 15 – 17
April, 1991)”, Selected Papers, Minsk, pp. 120 - 144.
Yamashita S., Shibata Y., (Eds.). 1997. Chernobyl: A Decade. Proc. Fifth Chernobyl
Sasakava Med. Coop. Symp., Kiev, 14 - 15 October, 1996, Elsevier Sci. Publ.,
Amsterdam.
Zalutskaya A., Bornstein S.R, Mokhort T., Garmaev D. 2004. Did the Chernobyl incident
cause an increase in Type 1 diabetes mellitus incidence in children and
adolescents? Diabetologia, vol. 47, pp. 147-148.
Zhavoronok S.V., Каlinin А.L., Grimbaum О.А., Chernovetskyi М.А., Babarykyna N.Z.,
Ospovat М.А. 1998. Gepatoviruses B, C, D, G markers at suffering from the
Chernobyl catastrophe populations. Public Health, № 8, pp. 46 – 48 (in Russian).
Zakrevsky А.А., Nikulina L.I., Martynenko L.G. 1993. Early postnatal adaptation of
newborns whose mothers were under radiation impact. Sci.- Pract. Conf.:
“Chernobyl and Public Health”. Kiev, Abstracts, Part 1, p. 116 (in Russian).
Zapesochnyi А.Z., Burdyga G.G., Tsybenko М.V. 1995. Irradiation in utero and
intellectual development: complex science-metrical analysis of information flows.
Materials Inter. Conf. “Actual and prognostic infrigments of psychical health after
nuclear catastrophe in Chernobyl. 24 – 28 May 1995. Kiev, Ukraine”, Kiev, p. 312
(in Russian).
Zubovich V.К., Petrov G.А, Beresten’ S.A., Kil’chevskaya Е.V., Zemskov V.N. 1998.
Human milk characters and babies health in the radioactively polluted areas of
Belarus. Public Health, № 5, pp. 28 – 30 (in Russian).
Yablokov A.V. 1997. Nuclear mythology. Ecologist’ note on Nuclear Industry. Moscow,
“Nauka” Publ., 272 p. (in Russian).
Yablokov A.V. 2001. Myth on insignificance of the Chernobyl catastrophe consequencies.
Moscow< Center for Russ. Ecol. Policy Publ., 112 p. (in Russian).
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CHAPTER 2
Is it Safe to Live in Territories Contaminated with Radioactivity
Consequences of the Chernobyl accident 20 years later
E.B. Burlakova1 and A.G Nazarov2
1
Emanuel Institute of Biochemical Physics, Russian Academy of Sciences , Moscow
2
“Union of Chernobyl” Moscow committee
(Translated by T.A. Sapego)
Introduction
The key criterion for determining the severity of any catastrophe, natural or
technogenic, is its impact on the health of people and the conditions of their continued
habitation in the effected territories. The Chernobyl catastrophe, which is the severest one
in human history, has been treated ambiguously. There are known efforts of the
International Atomic Energy Agency (IAEA) and the Ministry of Atomic Energy of
Russian Federation (Minatom) to underrate the consequences of the Chernobyl NPS
accident on the health of both the liquidators (clean-up workers of the Chernobyl accident)
and also residents of the affected regions. As is shown in this book (see Chapter 6), the
IAEA experts, supported actively by the officials from the Minatom and USSR Ministry of
Health and appealing to the results of their "independent expertise" (1988), declared that
the territories within the zone of the Chernobyl accident are adequate for safe living.
Similar claims are heard in statements made by IAEA officials now, 20 years after the
accident. We do know the attitude of residents of the affected regions to such an assessment
of conditions of "safe" living in the Chernobyl zone; In 1988-1989, public movements and
social organizations formed and demanded the disclosure of secret information concerning
the Chernobyl accident, the implementation of measures for the decontamination of the
affected areas and the rendering of state help for the people who had suffered.
Studies of radiation effects on the health of the liquidators and the population of
the Chernobyl NPS zone were initiated by several medico-biological institutions almost
immediately after the accident. One of the first scientists who began stationary studies on
the genetic consequences of the catastrophe was V.A. Shevchenko, an eminent Russian
radiation geneticist, deceased from cancer not long ago.
During the first several years after the Chernobyl accident many aspects of
radiation effects on the human organism remained unclear. The studies required a great
number of laboratory experiments on animals; experiments involving various aspects of
radiation effects were performed at many research institutes of the Academy of Sciences
and other institutions. Between 1987-1998, at the Emanuel Institute of Biochemical
Physics, Russian Academy of Sciences, a series of studies on the effect of low-dose lowlevel irradiation on biophysical and biochemical parameters of the genetic and membrane
apparatus of the cells of organs of exposed animals were carried out.
At present, the experimental data obtained are being analyzed and generalized. We
apologize to the reader for the abundance of scientific terms in this work that may only be
familiar to specialists or radiobiologists. Later on we intend to convert the conclusions and
experimental results, which, we believe, are of theoretical importance, to a language more
easily understood by non-specialists. Some of the purely scientific concepts;
methodological radiobiological argumentation and tabular data may be omitted by a nonspecialist upon first reading. Nevertheless, we found it necessary to retain them in this book
as new theoretical material – facts, accumulated for more than 10 years of experimental
studies, giving evidence and confirmation of the inferences and conclusions made.
49
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Analysis and Generalization of Experimental Data
We investigated the structural parameters of the genome (by the method of DNA binding to
nitrocellulose filters), structural parameters of nuclear, microsomal, mitochondrial and
plasmic (synaptic and erythrocyte) membranes (by the method of spin probes localized in
various layers of membranes), the composition and oxidation degree of membrane lipids,
and the functional activity of cells – the activity of enzymes, relationships between
isozymic forms and regulating properties [1, 2, 3].
We also investigated the effect of low-level irradiation on the sensitivity of cells
and biopolymers to subsequent action of various damaging factors, including high-dose
irradiation. The animals were exposed to a source of 137 Cs γ-radiation at the dose-rates 41.6
x 10-3, 4.16 x 10-3, and 0.416 x 10-3 mGy. The doses were varied from 6 x 10-4 to 1.2 Gy.
As a result of the studies performed, the following conclusions were made:
1.
2.
3.
4.
5.
The dose dependence of the radiation effect may be non-linear, non-monotonic,
and polymodal in character.
Doses that cause extreme effects depend on the irradiation dose-rate (intensity).
Low-dose irradiation causes changes (mainly enhancement) in sensitivity to the
action of other damaging factors.
The effects depend on the initial parameters of biological objects.
Over certain dose ranges, low-level irradiation is more effective with regard to the
results of its action on an organism or a population than acute high-level radiation.
We explain the non-linear and non-monotonic dose–effect dependence that we obtained in
our experiments with low-dose low-level irradiation by changes in the relationship between
damages, on the one hand, and reparation of the damages, on the other hand [4]. With this
kind of irradiation the reparative systems either are not initiated (induced), or function
inadequately, or are initiated with a delay, i.e., when the exposed object has already
received radiation damages.
It is difficult to predict the dose dependence for the effect, which is a result of the
interaction of several subsystems, when each of the subsystems is sensitive to a certain
factor and exhibits its own characteristic response to increasing dose.
Generally speaking, one can hardly expect a monotonic increase in the resulting
radiation effect with increasing dose because the determining factor here is not solely the
reaction of each individual subsystem but the sign (direction) and character of their
interaction.
In particular, the experiments showed that the radiation effect on an organism,
along with its direct action on the structural and functional biological subsystems, mobilizes
and activates the protective systems of reparation, adaptation, etc., whose regulating role is
compensation and minimization of the direct irradiation effect, restoration of functions, and
repairing the damages. After the initiation of reparative processes, the resulting (residual)
effect depends on the relationship between the direct (irradiation) and reverse (restoration
and compensation) processes, which is different for each separate irradiation dose.
Recently, the absence of reparation (the mechanism of repair of damages) at low
irradiation doses was shown at the cell level, and the complex character of the dose
dependence was confirmed [5, 6]. Previously, we published a scheme of dependence of
damages on irradiation dose, which shows the differences for different dose ranges (see [1,
2, 4]). According to the scheme, the quantitative characteristics were similar for the doses
that differed by several orders of magnitude; in a certain dose range the effect was opposite.
50
ECRR 2006: CHERNOBYL 20 YEARS AFTER
The results obtained and supported by numerous experiments are important
because the above dose dependences make it possible to come to a conclusion about the
radiogenic or non-radiogenic character of changes observed in an irradiated organism.
Along with the overwhelming majority of researchers, we think it indisputable to conclude
that a monotonic, nearly linear, increase in the irradiation effect on an organism with
increasing irradiation dose is (or, at the present level of knowledge about high dose effects,
may be) evidence for its radiogenic nature.
Nevertheless, the results of many years of our experimental studies do not favour
the opposite conclusion: that the absence of a direct dose dependence and its non
monotonic character is evidence for the absence of the relation between the effect and
radiation. In our opinion this relation and the radiogenic nature of the effect are equally
indisputable, as is the case with high doses: it is mainly that this character of the dose–
effect dependence seems natural in the case of low-dose low-level irradiation.
Often, for processes that play a certain role in damaging biomacromolecules, one
should consider their participation, not only in damaging or restoring events, but also their
role in the regulating network of cells that determine the character of response to
irradiation. For example; active oxygen species may participate in normal metabolic
processes, radiation damage (of DNA molecules, proteins, lipids, and membranes) and
regulating processes in cells responsible for division, reproduction (proliferation),
differentiation and programmed death of cells (apoptosis).
It is difficult to predict the resulting overall response of a cell without the
knowledge of the response of each of its systems and their dependence on the intensity,
mode and dose of irradiation and the overall nature of their radio-sensitivity. However, it is
possible to make a general conclusion that the resulting response of an organism, cell or
population will depend, to a large extent, on the balance of opposite processes, e.g.,
apoptosis and proliferation.
In the article of Hardy and Start [7], a mathematical model of such a balance is
suggested; the model allows for the behavior of a cell after irradiation: the cell will be
either:
• Ruined, with the probability P(apoptosis), or
• Divided, with the probability P(proliferation)
• Or will remain unchanged, with the probability P(no change).
• The balance of these processes will determine the character of the dose
dependence.
Experimentally, we studied the trends of changes in three parameters related to extreme
points on the dose dependence curves:
• Time, during which the effect reaches the maximum;
• Dose, at which the maximum is reached;
-and the effect at the extreme points, depending on the irradiation intensity, varied by
an order to two orders of magnitude (from 0.06 to 0.6 and 6.0 cGy).
From rates of change in the DNA structural parameters we determined that a
decrease in the irradiation intensity results in an increase in the time of the effect reaching
its maximum, a decrease in the dose of the maximum effect, and a decrease in the effect at
the extreme point. Similar trends were determined for nearly all parameters of membranes.
Exceptions were the data obtained for the lowest irradiation intensity, at which maximum
effects were observed. With regard to the fact that the maximum effects are observed at the
time of initiation of the reparative systems, the trends we determined make it possible to
51
ECRR 2006: CHERNOBYL 20 YEARS AFTER
conclude that the lower the irradiation intensity, the later the reparative systems are
initiated.
The results obtained are evidence for a high biological activity of low dose
irradiation and different mechanisms on the cell metabolism than those for high doses.
Another theoretical generalization of the experimental data, which is of great
practical importance, is the phenomenon that we and other authors noted: enhancement of
the sensitivity of living organisms irradiated with low doses and enhancement of the
susceptibility of biochemical processes to the subsequent action of damaging agents. This
phenomenon may be explained plausibly by the radiation-induced instability of the
genome.
Note that the genome restructuring and, as a result changes in the accessibility of
the genetic material to regulating effects, play an important role in these processes. In our
work [8] and the work of others [9, 10], the expression of regulating genes (initiation,
induction, or starting functioning) after low-dose low-level irradiation of organisms was
observed. These findings are of great importance because changes in the sensitivity to the
action of many other damaging factors after low dose exposures may be (and actually are)
the cause of diseases and disturbances in the adaptive ability of man. It should be
emphasized that these processes are closely related to aging, which is a process also
characterized by enhancement of the sensitivity to damaging factors and the probability of
death from these factors increases with age.
We do not intend to give a full explanation regarding changes in biochemical and
biophysical processes occurring in organisms exposed to low doses. However, the data
presented here show that these changes may cause various somatic diseases. To determine
the radiogenic nature of these diseases it is not necessary to perform mathematical
processing of the dose dependences over the entire range of doses received. The criteria for
a conclusion regarding the radiogenic nature of diseases should be worked out by taking
into account specific radiation-induced disturbances in the cell metabolism at the cell,
population, organ, and organism levels.
It is important to study the effect of low-level irradiation at the population level.
The primary effect detectable in various systems is a change (increase) in the variance in
many population indices and decrease in stability, including adaptation. For example; in an
exposed human population the number of people whose blood cells do not give an adaptive
response to subsequent exposures has increased [11]. The correlation between indices,
which is most pronounced for groups who received low doses of radiation, varies. Our
studies showed that the correlations between indices of the antioxidant and immune status
of ChNPS liquidators were changed [1].
Radiation-induced changes in the population structure result in an unpredictable
response of the population to various events. In the work by A.P. Akif'ev et al. [12], an
apparently healthy population of the posterity of exposed Drosophila exhibited a so-called
‘populational breakdown’ in one of its generations and was ruined by a law other than that
for other generations. In the work by I.I. Pelevina et al. [13], it was shown that 15
generations of cells irradiated with the doses 10 to 50 cGy "remember" the irradiation and
respond to external stimuli differently than the control.
According to A.A. Yarilin [14], low-level ionizing radiation is a source of
biologically significant signals. Having analyzed changes in the immune system from this
point of view, the author came to the conclusion that inadequate signals brought about by
low-level irradiation result in disturbances in the spatial organization of the immune system
and its integrating functions in the organism. In a sense, the effect is similar to the aging of
the immune system and in the organism.
52
ECRR 2006: CHERNOBYL 20 YEARS AFTER
In this work, much attention is given to free radical reactions caused by irradiation,
in particular promotion of oxidation of fats (lipids) and associated changes in the
composition and functional activity of membranes, restructuring of the membrane
apparatus, increase in the concentration of free radicals in various components of cells,
antioxidant activity of regulating enzymes, changes in physicochemical properties and
regulation of the activity of the genome (expression and repression of genes).
In experiments in animals and in studies on biochemical parameters of formal
elements and blood plasma of man, common trends in the effects of low-dose low-level
irradiation were observed, namely disturbances in the correlations between oxidizability
and antioxidant properties of lipids and between structural changes in lipids localized in
various portions of membranes [15]. These changes result in a loss of the regulating
functions of membranes. Similar trends were observed for structural changes in DNA and
the genome [16]. At present, there are many works published that verify the crucial role of
the signaling functions of active oxygen species in the regulating network of cell response
to damaging impacts, radio-sensitivity and instability of the genome.
Therefore, changes in the composition, structure, and functional activity of
membranes are primary symptoms of disturbances in the cell metabolism and a predicting
factor in the development of a disease.
The above trends follow from the generalization of a series of experiments and are
of a common biological character. Therefore, they may be used in analyzing the state of
health of Chernobyl residents and answering the question whether it is safe to live on the
radiation-contaminated territories within the zone of the Chernobyl accident.
Table 1. Parameters of the antioxidant status for the liquidators before and after one month
vitamin therapy
Parameter
Control
DBpl (double bonds in plasma
lipids, number of DB/mg lipids
1018)
DBer (double bonds in
erythrocyte lipids, number of
DB/mg lipids 1018)
Vitamin Е
Vitamin А
Reduced glutathione
SOD (superoxydismutase)
GP (glutathione peroxydase)
GR (glutathione reductase)
Hem1 (hemolysis of
erythrocytes)
Hem2 (hemolysis of
erythrocytes after initiation of
POL)
MDA1 (malonic dialdehyde in
erythrocytes)
MDA2 (malonic dialdehyde in
erythrocytes after initiation of
53
0.32
Liquidators
before therapy
0.27
Liquidators
after therapy
0.39
0.303
0.15
0.47
20.9
2.99
19.53
125.41
7.2
5.12
7.23
15.59
2.67
20.34
137.53
9.28
5.75
5.79
21.59
2.82
15.32
105.30
4.93
5.97
8.65
7.62
11.32
11.04
1.93
3.90
1.89
1.95
2.58
1.89
ECRR 2006: CHERNOBYL 20 YEARS AFTER
POL)
τcl (time of rotary correlation of
spin probe N1 in erythrocyte
membranes)
τclI (time of rotary correlation of
spin probe N2 in erythrocyte
membranes)
CP (ceruloplasmine)
TF (transferine)
Free radicals with g-factor 2.0
1.08
2.06
1.04
1.94
2.22
1.63
1.23
0.78
0.69
0.80
1.03
2.03
0.86
0.77
1.14
Table 1 shows some indices of the state of health of liquidators who worked in the zone of
the CNPS accident in 1986-1987.
Along with parameters of the antioxidant (AO) status of the liquidators, we
measured the parameters of the immune status, which also were found to be significantly
below normal, even five years after the irradiation [3]. At different times after the accident,
we investigated erythrocytes and blood plasma from 104 liquidators who worked in
Chernobyl between 1986-1987 and received irradiation doses from 0.1 to 150 cSv. We
established a decrease in the level of antioxidants (tocopherol, vitamin A, and
ceruroplasmine), enhancement in the concentration of the products of free radical reactions
and a high level of free radicals, a more rigid membrane, and a break in the correlation
between oxidizability and AO activity and viscosity of the lipid and protein components.
Some of the liquidators were administered with antioxidants (vitamins) for a
month and then were examined. It was shown that 70% of indices of the AO and immune
status were normal after the antioxidant therapy.
It was important to examine liquidators of various ages to determine their reaction
to the irradiation doses received. In fact, the content of antioxidants decreases and the
activity of protective antioxidant enzymes varies with age. Six years after the accident we
determined the age-related dependences of the activity of the key AO enzymes in the blood
(superoxydismutase, glutathione peroxidase, and glutathione reductase) of liquidators
between the ages of 25 to 60 years. The control was 35 men and women from the same age
group.
For liquidators, enzymes of the glutathione cycle were the most sensitive to low
dose radiation links with the AO system. Changes in all links of the AO system of
liquidators promote formation of the pro-oxidant state. According to our data, doses above
average produce a prolonged damaging effect on the AO system. As was noted above, a
decrease in the SOD and GP activity in middle-aged liquidators and a drastic decrease in
the GR activity in liquidators older than 55 years were recorded over the entire dose range
studied. Previously, we showed that pre-cancer changes in the cell metabolism are
characterized by a decrease in the SOD/GP relationship and a low level of GR activity.
Both these indices were recorded for the older liquidators.
The results obtained in this work on the remote consequences of low-level lowdose irradiation on the protective AO system of people show that the most sensitive
members of a population are children and young people below the age of 30 years; middleaged people are the most resistant to irradiation. This conclusion should be taken into
account when determining high risk groups for people engaged in industries involving
chronic low-level irradiation.
As for young people, low doses of low-level irradiation cause an imbalance in the
AO system, which is characteristic of an aging organism [17].
54
ECRR 2006: CHERNOBYL 20 YEARS AFTER
In the works by L.S. Baleva et al., some of these parameters were measured for
children living within the contaminated territories. An enhanced concentration of the
products of peroxide oxidation of lipids (POL) and a lower activity of AO enzymes of the
glutathione cycle were detected. The most drastic changes were detected in children born in
1986-1987 who remained living within the radionuclide-contaminated territories [18];
serious deviations from normal were detected also for children born before 1986 who
survived the accident and remained living within the contaminated territories (Table 2).
Table 2 Biological monitoring of children of the Bryansk region
(Baleva and Sipyagina [18])
Parameters
4.55±0.04
2.06±0.03
Groups of children
Intrauterine
In utero development under
irradiation
conditions of
1986-1987 elevated radiation
background 1988
4.96±0.05
4.49±0.07
1.89±0.05
1.81±0.06
3.56±0.01
1.5±0.02
30.86±0.14
.69±0.07
121.9±8.8
53.1±5.7
72.8±6.5
11.72±0.45
29.34±0.18
2.81±0.12
61.4±6.3
69.8±3.3
78.9±5.1
3.89±0.39
33.1±0.21
3.38±0.18
114.0±9.2
112.3±6.5
55.2±5.6
8.91±0.51
34.2±0.28
3.94±0.20
85.2±5.1
86.1±8.7
56.0±4.8
23.71±0.31
5.91±0.37
7.87±0.58
3.08±0.36
4.51±0.25
36.8±1.1
55.2±1.3
49.1±1.5
42.0±1.2
Born before
July 4, 1986.
MDA, nmol/ml
Hydroperoxides,
a.u./ml
АОА, %
GP
SOD
CP, a.u.
Fe (3+), TF a.u.
α-1 antitrypsin,
a.u./ml
Extracellular DNA
in blood plasma
(mg/ml)
Content of
endonuclease in
blood plasma, a.u.
Control
The Medical Radiological Research Center, Russian Academy of Medical
Sciences, performs constant monitoring on the state of health of liquidators and residents of
the contaminated regions. Surveys (1991-1996) revealed a drastic aggravation of the health
of liquidators during this period. In 1991, about 20% of liquidators were assigned to Group
I (apparently healthy); 50%, to Group II; and 27%, to Group III. In 1996, 8% were
apparently healthy (Group I) and 68% of people had three or more chronic diseases (Group
III). A still more serious situation was recorded in 2002-2003. Among the liquidators living
in Moscow and the Moscow region, none were apparently healthy; 100% had three or more
chronic diseases. For St. Petersburg and Leningrad Region, 85% were assigned to Group
III. The number of liquidator-invalids was 37% (31% in 1999); the Chernobyl-related
invalidity accounted for 95%. The most frequent causes of invalidity were diseases of the
central nervous system (70%), blood circulation system (23%), and locomotor apparatus
(6%). Polymorbidity, i.e., three or more chronic diseases, was recorded for 59% [19].
55
ECRR 2006: CHERNOBYL 20 YEARS AFTER
A comparison of the data obtained in the Obninsk Medical Center in 1993 and
2003 on different diseases among liquidators and the population of Russia (per 100,000)
showed that the above tendencies persist [20, 21], which is evident from Table 3.
Table 3 Liquidators to population of Russia morbidity ratio (1993 and 2003)
Classes of diseases
Neoplasms
Malignant diseases
Endocrine diseases
Diseases
of
blood
and
hemopoietic organs
Mental diseases
Diseases of blood circulation
system
Gastrointestinal diseases
All classes of diseases
Ratio 1993 [20]
0.9
1.6
18.4
3.6
Ratio 2003 [21]
4.55
9.6
4.3
9.95
-
3.7
1.5
1.9
1.59
The groups of incipient cases among liquidators exceed those for the population of
Russia by a factor of 5 to 10 with regard to diseases of the central nervous system (CNS)
and cardiovascular diseases. The data on three Russian regions, where an analysis of
chronic diseases was performed in 2001-2003 (Table 4), were kindly supplied by Dr. I.V.
Oradovskaya.
Table 4 Incidence rate of chronic diseases of liquidators (monitoring data) in
2001-2003 [21]
Moscow+
region
Diseases
2003
2002
n=110 n=133
Diseases of blood circulation system 98.18 85.71
1
Atherosclerosis+hypertensive 82.72 56.39
disease
2
Coronary disease
71.81
48.87
3
VVD, NCD
13.64
25.56
4
CVD:Discirculatory
86.36 49.62
encephalopathy
41.99
Pathologies of nervous and mental 80.0
spheres
5
Asthenic syndrome,
53.63 20.30
neurasthenia
6
Syndrome of high fatiguability 62.72 19.55
7
Organic diseases of
14.54 12.78
craniocerebrum
8
Polyneuropathy
9.09
3.03
96.36 72.18
Diseases of alimentary organs
9
Diseases of gastrointestinal
95.45 51.88
St.Petersb.+
region
2003
2002
n=104 n=108
85.58 72.22
63.46 47.22
Krasnoyarsk
region
2003
2002
n=74
n=194
85.14 81.44
58.11
44.32
40.38
14.42
59.62
43.52
13.89
42.59
36.49
21.62
71.62
26.80
25.77
51.03
34.62
25.93
82.43
40.72
15.38
9.26
13.51
9.28
17.31
5.77
18.52
2.78
78.38
25.68
22.68
14.43
0.96
66.35
56.73
—
52.78
47.22
2.70
64.87
47.30
4.12
63.92
42.27
56
ECRR 2006: CHERNOBYL 20 YEARS AFTER
tract (chronic gastritis,
gastroduodenitis, ulcer of
stomach &duodenum)
10 Chronic cholecystitis,
cholecystopancreatitis
11 Fatty hepatosis & dystrophy of
liver
Diseases of musculoskeletal system
12 Deforming osteochondrosis of
backbone
13 Chronic polyarthritis,
osteoarthrosis
14 Osteoarthrosis
Other chronic pathologies
15 Diseases of veins
16 Multiple caries
17 Diseases of the thyroid
18 Non-infectious pathology of
vision
19 Radiation-induced cataract
20 Non-infectious pathology of
hearing
21 Non-allergic dishydrotic
eczema
22 Urolithiasis
23 Chronic pyelonephritis
24 Diabetes mellitus, type II
25 Benign tumors
26 States after resection of
malignant tumors
27 Apparently healthy
28 Polymorbidity (3 and more
diseases)
29 Chronic diseases (total)
30 Invalidity
Including:
Group I
Group II
Group III
31 General diseases
32 Total
49.09
40.60
25.96
20.59
45.95
41.24
17.27
5.26
9.62
5.56
16.22
8.69
100.0
91.81
66.17
56.39
53.85
48.08
53.7
46.30
52.70
48.65
52.06
44.32
39.09
14.29
1.92
6.48
8.11
7.22
31.82
12.78
10.58
6.48
1.35
1.56
8.17
10.0
42.72
50.0
6.79
6.02
30.08
9.77
15.39
0
26.92
8.65
10.19
3.72
26.85
8.33
4.05
1.35
24.39
16.22
4.12
4.12
22.16
6.19
8.18
6.36
3.76
1.50
0
0.96
4.63
0.93
2.70
4.05
2.06
1.55
3.63
0.75
—
—
—
26.36
4.54
4.54
35.45
2.72
16.03
—
3.01
14.10
1.50
10.58
—
0
12.50
3.85
11.11
—
0.93
16.67
2.78
13.51
1.35
2.70
13.51
4.05
7.22
0.52
2.06
4.12
4.12
0
100.0
0
84.21
0
86.54
0
72.22
0
77.03
2.06
74.23
100.0
35.45
0.9
25.45
9.09
19.09
54.55
96.99
33.08
0.75
23.31
8.27
19.08
51.13
100.0
26.92
0
20.19
5.77
5.77
32.69
89.81
25.93
0.93
13.21
12.04
3.72
29.63
86.49
43.24
4.05
18.92
20;27
5.41
48.65
97.94
38.66
1.55
18.04
19.07
3.61
42.27
It is evident from Table 4 that diseases specific for middle-aged people prevail.
Indeed, the age of liquidators was several years younger than would be expected from the
above assessment of their state of health.
In the works by A.F. Tsyb and V.K. Ivanov, et al. [22], dose dependences of noncancer diseases of liquidators were considered.
The studies resulted in determining statistically significant dose dependences for
the whole cohort of liquidators stratified by age at the time of arrival to the zone, date of
57
ECRR 2006: CHERNOBYL 20 YEARS AFTER
arrival, and region of residence with regard to the following non-oncological classes of
diseases:
• Diseases of the endocrine system [ERR = 0.58 with 95% CI (0.30 and 0.87)];
• Mental diseases [ERR = 0.40 with 95% CI (0.17 and 0.63)];
• Diseases of the central nervous system and sensory organs [ERR = 0.35 with 95%
CI (0.19 and 0.52)];
• Diseases of alimentary organs [ERR = 0.24 with 95% CI (0.05 and 0.43)];
• Cerebrovascular diseases [ERR = 1.17 with 95% CI (0.45 and 1.88)];
• Essential hypertension [ERR = 0.52 with 95% CI (0.07 and 0.98)].
The results obtained should be considered as preliminary and requiring
verification. Further surveys over the chosen cohort of liquidators will eliminate the
ambiguity in the quantitative assessment of the results and will make it possible to isolate a
radiation component in pathologies by taking into account all risk factors of both the
radiogenic and non-radiogenic nature.
Foreign physicians are inclined to ascribe all the health troubles of the liquidators
and the population (children and adults) to either faults in medical care and recording or
adverse social conditions. It would be unjust to disregard the harshness of living conditions
for the people of Russia. However, a local comparison of irradiated and non-irradiated
contingents living under the same conditions and even engaged in harmful or heavy
industries makes it possible to draw a conclusion about the obvious contribution of
irradiation to the loss of health of the irradiated population, in particular children and
liquidators. We have already noted that the relation of the effects with doses of low-level
irradiation does not necessarily obey the same laws as those for high doses and that the
effect may be not only non-linear but also non-monotonic. Hence, detecting the radiogenic
nature of low and high-dose effects should be different; the same criteria and approaches do
not hold. The criteria for determining the dose-effect correlation should be based on data of
molecular epidemiology. At present, a promising approach is the search for relationships
between somatic diseases and cytogenetic disturbances in the organism of irradiated people.
The number of studies in which this relationship has been detected has grown rapidly.
Conclusion
A series of experimental medico-biological, biochemical, biophysical, and
cytogenetic studies performed during the post-Chernobyl period with the use of data on the
effect of the CNPS accident on the health of liquidators and the population of the radiocontaminated regions of Ukraine, Russia, and Belarus revealed two common biological
trends. One of these shows with a high level of statistical confidence, the role and effect of
low doses of low-level irradiation on man and living things. Another, closely related to the
first one, shows an increase in the sensitivity of objects exposed to low level irradiation to
other damaging factors including higher irradiation doses.
In examining these trends some others were discovered that show various specific
aspects and phenomena of low-dose radiation impacts. In particular:
• The correlation between the destructive effects of irradiation and the restoration
(repair) of damages.
• The decisive protecting role of cell membranes; the great importance of the AO
stability and immune status toward the effects of low doses.
• The complicated nature of dose dependences on effects involving the interaction
of several subsystems.
• The informative (signaling) nature of biologically significant low-level radiation
stress.
58
ECRR 2006: CHERNOBYL 20 YEARS AFTER
•
•
Specific features in the response of a population to the action of low doses.
Others described in this work.
Although some of these findings require further studies, the trends and phenomena
discovered may become a theoretical basis for making prognoses on the state of health of
the victims of the Chernobyl accident and practical recommendations for improvement of
the present situation.
The results of surveys and biological monitoring of children and adults of
Chernobyl point unambiguously to a steady, rapid, and dramatic (for an individual human
life) deterioration of health of all victims of the radiation impact of the Chernobyl accident.
The effect manifests itself in the processes of rapid aging of the organism and the
development of so-called polymorbidity, i.e., a complex of three or more chronic diseases,
among victims of irradiation. At present, the extent of this pathology among liquidators
living in Moscow and the Moscow region is 100%; for the Leningrad region, 85%.
An important result of the studies performed is the assessment of the effects of low
doses of irradiation on people of different age categories. The most resistant to irradiation
are middle-aged people - children and young people below the age of 30 and old people
over 60 are the least resistant. This is an important practical finding; it makes it possible to
work out prognoses for the rates of real employment for a population of various age groups
in radio-contaminated regions and industries involving low-level irradiation.
The question put in the title - whether it is safe to live on radiation-contaminated
territories - is controversial and was provoked by the position of the International Atomic
Energy Agency (IAEA). For many years and particularly in the latest declaration (2005)
[23], IAEA officials and experts have tried to persuade the world of their ideas or, more
exactly, to demand (without convincing arguments) that the world community accepts their
assurances about the safety of living within the regions contaminated by the Chernobyl
accident as well as assurances relating to the “excessiveness” of measures taken by the
Government on rendering adequate assistance to the population of the affected regions.
Every unprejudiced researcher, unbound by corporate interests, who has ever been
to the places of residence of the Chernobyl-sufferers, especially in the Russian (Ukrainian,
and Belarussian) remote regions, will consider the statement about the excessiveness of the
measures taken as shocking. From the scientific point of view, it can be stated that there is
no reliable evidence to be found for not only these mythical excessive measures but the
provision of even the minimum necessary conditions for the safety of the people living in
these regions – the victims of low-level irradiation. There is no adequate medical care or
social support even intended for the improvement of these living conditions.
Perhaps, it is one of the most important lessons of the accident, which is the
severest catastrophe in history, that any catastrophe is always irreversible, both for man and
nature. Consequently, the question about the feasibility of safe living within the radiationcontaminated territories is senseless. It is relatively safe to live, but not in Chernobyl.
References
Akif'ev A.P., Obukhova L.K., and izmailov D.M., Vestnik Rus.Akad.Nauk., 1992, vol. 32,
vol. 5, pp. 82-92. (in Russian)
Amundson S.A., Lee R.A., Koch-Paiz C.A., et al., Differential Responses of Stress Genes
to Low Dose Rate Irradiation, Mol. Cancer Res., 2003, 1 (6), pp. 445-452.
Baleva L.S., Sipyagina A.P., in the book “20 Years after Chernobyl Catastrophe”, 2006 (in
press). I.V.
Burlakova E.B., Goloshchapov A.N., Gorbunova N.V., et al., Radiats. Biol. Radioecol.,
1996, vol. 36, no. 4, pp. 610-631. (in Russian)
59
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Burlakova E.B., Goloshchapov A.N., Gorbunova N.V., Gurevich S.M., Zhizhina G.P., et
al., Radiats. Biol. Radioecol., 1996, vol. 36, no. 4, pp. 610-631. (in Russian)
Burlakova E.B., Goloshchapov A.N., Zhizhina G.P., and Konradov A.A. New aspects of
effects of low doses of low-level irradiation, Radiats. Biol. Radioecol., 1999,
vol.32, no. 1, pp. 26-34. (in Russian)
Burlakova E.B., Low Intensity Radiation: Radiobiological Aspects, Rad. Protection
Dosimetry, 1995, vol. 62, no. 1/2, pp. 13-18. (in Russian)
Burlakova E.B., Some specific features of action of low dose irradiation, Proceedings of the
24th Annual Meeting of the European Society of Radiation Biology, 1992, p. 88.
Burlakova E.B., Treshchenkova Yu.A., and Goloshchapov A.N., Radiats. Biol. Radioecol.,
2003, vol. 43, no. 3, pp. 320-323. (in Russian)
Crompton N.E.A., Izsahin M., Schweizer P. et al., Strahlenther. Oncol., 1997, Bd. 2, S. 58.
Hardy K. and Stark J., Mathematical models of the balance between apoptosis and
proliferation, Apoptosis, 2002, vol. 3, pp. 373-381.
Hooker A.M., Bhat M., Day T.K. et al., Rad. Res., 2004, no. 162, pp. 447-452.
Ivanov V.K., Chekin S.Y., Parshin V.S., et al., Non-cancer thyroid diseases among
children in the Kaluga and Bryansk regions of the Russian Federation exposed to
radiation.
M. Martin, F. Crechert, B. Ramount, and J-L. Lefaix, Activation of c-fos by Low-Dose
Radiation: Mechanism of the Adaptive Response in Skin Cells, Radiat. Res., 141,
118 (1995).
Mil Å.Ì., Erokhin V.N., Kasparov V.V., et al., Biofizika, 2001, no. 46 (2), pp. 548-572. (in
Russian)
Oradovskaya I.V., in the book “20 Years after Chernobyl Catastrophe”, 2006 (in press).
OradovskayaI.V., in the book “20 Years after Chernobyl Catastrophe”, 2006 (in press).
Pelevina I.I., Afanas'ev G.G. , Gotlib V. Ya., and Serebryanyi A.B., in the book â êí.
"Consequences of the Chernobyl accident: Human health" Ìoscow, Center of Ecol.
Pol. 1996, pp. 229-244. (in Russian)
Pelevina I.I., Aleshchenko A.V., Gotlib V.Ya., et al., Radiats. Biol. Radioecol., 2004, vol.
44, no. 3, pp. 278-282. (in Russian)
Radiation and risk Bulletin of the National Radiation-Epidemiology Register, MoscowObninsk, 1996, no. 8. (in Russian)
Report of IAEA experts., Vienna, 2005.
Vartanyan L.S., Gurevich S.M., Kosachenko A.I., et al., Age-related effects of low doses of
ionizing radiation on the state of enzymic AO system of blood of participants of
liquidation of consequences of the Chernobyl accident, Uspekhi gerontologii,
2004, no. 14, pp. 48-54. (in Russian)
Yarilin A.A., Radiats. Biol. Radioecol., 1997, vol. 37, no. 4, pp. 597-603. (in Russian)
60
ECRR 2006: CHERNOBYL 20 YEARS AFTER
CHAPTER 3
Mental, Psychological and Central Nervous System Effects: Critical Comments
on the Report of the UN Chernobyl
Expert Group «HEALTH» (EGH)
Konstantin N. Loganovsky, MD, PhD, Dr. Med. Sci.
Department of Radiation Psychoneurology, Institute for Clinical Radiology,
Research Centre for Radiation Medicine, Academy of Medical Sciences of Ukraine,
53 Melnikov Street, 04050, Kiev, Ukraine
Tel.: 380-44-452-1803; fax: 380-44-451-2330
e-mail: [email protected]; [email protected]; [email protected]
Background
International consensus exists that the mental health impact of theChernobyl accident is the
greatest public health problem. The UN Chernobyl Forum Expert Group «Health» (EGH)
has outlined four related areas of concern; stress-related symptoms; effects on the
developing brain; organic brain disorders in highly exposed clean-up workers and suicide.
A heated scientific discussion over whether the Central Nervous System (CNS) is
vulnerable to ionizing radiation has continued for more than a century. Both after the
atomic bombing in Japan and, particularly, after the Chernobyl accident the world’s
research interests into radio-cerebral effects have significantly increased together with an
augmentation of contradictions concerning brain radio-sensititvity. In spite of UNSCEAR2000 (Annex J), whose experts acknowledged only the psycho-social consequences of the
Chernobyl accident, the French IRSN agency identify the sensitivity of the CNS to low
dose exposure: «…today it is recognized that the CNS is a radio-sensitive organ whose
degree of dysfunction can be quantified by electrophysiological, biochemical and/or
behavioural parameters. Abnormalities in CNS function defined by these parameters may
occur at a low dose of whole body radiation…» (Gourmelon et al, 2005 — Institut de
Radioprotection et de Surete Nucleaire, Fontenay-aux-Roses).
Undoubtedly, the clean up workers of the Chernobyl accident are under the highest
risk of neuro-psychiatric disorders due to their greater exposure to both radiation and nonradiation factors of the disaster’s aftermath. However, until now there is a gap in
knowledge concerning the evidence-based estimation of their mental health. There are
many contradictions concerning neuro-psychiatric effects at exposure to low doses (<1 Sv),
e.g. whether such exposure is a risk factor for neuro-psychiatric disorders, particularly,
schizophrenia spectrum disorders and Chronic Fatigue Syndrome (CFS) There are no clear
data on cerebral radiation effects, cerebral radiation markers and dose–effect relationships.
In the currently available Working Draft, August 31, 2005 of the Report of the UN
Chernobyl Forum EGH «Health Effects of the Chernobyl Accident and Special Health Care
Programme» there are many gaps and even errors in the presentation of mental,
psychological and CNS effects. The main goal of this paper is to discuss the currently
available data and their limitations concerning the mental health aftermath of the Chernobyl
accident, the neuro-psychiatric effects of ionizing radiation and investigate the research and
measures for improving the mental health care of both the Chernobyl accident survivors and
the casualties of possible radiation accidents in the future.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Stress-related disorders
Consensus exists concerning stress-related disorders following the Chernobyl accident. As
it is presented in Chapter 15 of the Report of the UN Chernobyl Forum EGH, increased
levels of depression, anxiety (including post-traumatic stress symptoms) and medically
unexplained physical symptoms have been found in Chernobyl-exposed populations
compared to controls (Viinamaki et al, 1995; Havenaar et al, 1997a; Bromet et al, 2000).
Studies have also found that exposed populations had anxiety symptom levels that were
twice as high and were 3-4 times more likely to report multiple unexplained physical
symptoms and subjective poor health than the controls (Havenaar et al, 1997b; Allen and
Rumyantseva; 1995; Bromet et al, 2002).
It was noted that these mental health consequences in the general population were
mostly sub-clinical and did not reach the level of criteria for a psychiatric disorder
(Havenaar et al, 1997b). Nevertheless these sub-clinical symptoms had important
consequences for health behavior, specifically medical care utilization and adherence to
safety advisories (Havenaar et al, 1997a; Allen and Rumyantseva, 1995).To some extent,
these symptoms were driven by the belief that their health was adversely affected by the
disaster and the fact that they were diagnosed by a physician as having a «Chernobylrelated health problem» (Bromet et al, 2002; Havenaar et al, 2003).
In the liquidator cohort (n=507) a very high level of mental disorders (84.42%) has
been revealed. This is significantly higher than in inhabitants of radioactively contaminated
territories of the Russian Federation (60.9%) and in populations of “clean” areas (47%). As
opposed to populations where sub-clinical disorders are dominating, the proportion of
clinically significant mental disorders among liquidators is quite large. Somatization and
depression are especially pronounced (Rumyantseva et al, 1998).
Brain damage in utero
If the radio-vulnerability of an adult brain is accepted, it is axiomatic that the developing
brain is extremely radiosensitive. Epidemiological studies on individuals who survived the
atomic bombing of Hiroshima and Nagasaki and were exposed in utero confirm the
vulnerability of the developing fetal brain to radiation injury. Severe mental retardation,
lowering of intelligence quotient (IQ) and worsening of school performance, or the
occurrence of microcephalia and seizures, especially after exposure at 8–15 and 16–25
weeks after fertilization were revealed (Otake and Shull, 1984, 1998; ICRP Publication 49,
1986; Shull, 1997; Shull and Otake, 1999). A recent re-analysis of the dosimetry data
indicated that the dose threshold for the development of mental retardation after intrauterine irradiation at gestation terms of 8–15 weeks is 0.06–0.31 Gy. At gestation terms of
16–25 weeks, it is 0.28–0.87 Gy (Otake et al, 1996). The question of increased lifetime
prevalence of schizophrenia in survivors prenatally exposed to atomic bomb radiation is
still open to discussion (Imamura et al, 1999).
The current concept about prenatal radio-cerebral effects is that 1 Sv of fetal
exposure at 8–15 weeks of gestation reduces the IQ by 30 points. Correspondingly, it is
assumed that each 100 mSv of prenatal irradiation lowers the IQ by no more than 3 points.
The excess of severe mental retardation is 0.4 per 1 Sv at 8–15 weeks and, to a lesser
extent, at 16–25 weeks of gestation (European Commission on Radiation Protection 100,
1998; ICRP Publication 84, 2000). Thus, the evidence-based radio-neuro-embriologic
effects in humans are: 1) A dose-related intelligence reduction right up to mental
retardation; 2) microcephalia; 3) seizures. This IQ deterioration depends upon the period of
cerebrogenesis, when the exposure took place. However, other possible radio-neuroembriological effects, such as schizophrenia and epilepsy are still being discussed.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Obviously, a great deal of concern has been expressed about the developing brain
in children who were in utero when the accident occurred (Nyagu et al, 1993, 1996a,b,
1998, 2002a; Igumnov, 1996; Kolominsky et al, 1999; Kozlova et al, 1999; Loganovskaja
and Loganovsky, 1999; Igumnov, Drozdovitch, 2000). On the one hand, the lowest level of
exposure in which mental retardation was found in the offspring of survivors of Hiroshima
and Nagasaki was higher than the highest level of exposure reported for most Chernobyl
populations. On the other hand, there is a general belief that the brains of Chernobyl
exposed children have been damaged. Thus, the World Health Organization conducted the
Pilot Project on Brain Damage In-Utero within the framework of the International Program
on the Health Effects of the Chernobyl Accident (IPHECA).
However, in spite of our numerous objections, on page 132 of Chapter 15 in the
Report of the UN Chernobyl Forum EGH, Working Draft, August 31, 2005, a clear
misinterpretation is still present as follows: «…Thus, the WHO conducted a pilot study of
brain damage in-utero and DID NOT find that exposed children had elevated rates of
mental retardation compared to controls». As a matter of fact, it must be as follows (World
Health Organization, 1996, p. 402):
«…3. Analysis of the results of the investigations in the three countries has shown the
following:
• Incidence of mental retardation in the lowest degree in the main group of
children is higher when compared with the control group.
• An upward trend was detected in cases of behavioral disorders and in changes
in the emotional problems in the children within the main group.
• Incidence of borderline nervous and psychological disorders in the parents of
the main group is higher than that of the controls.
4. On the basis of these investigations it is impossible to arrive at a final conclusion on
any relationship between an increase in the number of mentally retarded children and
the ionizing radiation factor due to the Chernobyl accident. The results obtained are
difficult to interpret and require verification. It is necessary to continue well planned
epidemiological investigations and dosimetric follow-up of the project» (World Health
Organization, 1996).
The principal conclusion that has been drawn on the basis of implementation of the
IPHECA pilot project «Brain Damage in Utero» was the following: «Arrested mental
development and deviations in behavioral and emotional reactions is observed in a section
of the children exposed in utero. The contribution of radiation to such psychological
changes still remains unclear due to the absence of individual dosimetry data»
(World Health Organization, 1996, p. 415).
Actually, as was presented in the EGH Report, two recent well-designed studies using
standard batteries of neuropsychological tests failed to find systematic differences in
children exposed in utero (Litcher et al, 2000; Bar et al, 2004). In the Litcher et al. study
(2000), 31% of the mothers of evacuee children believed that their child had memory
problems compared to 7% of controls even though there were no differences in actual
neuro-psychological test performance or school grades. However, no dosimetric data were
available, and there were no normative data in Ukraine for the measures used in the study
(Bromet et al, 2000; Litcher et al, 2000). Moreover, the IQ tests were applied selectively:
Litcher et al. (2000) assessed children’s cognitive functions using spatial intelligence
(Symbolic Relations subtest of the Detroit Test), attention and memory only and excluded
verbal intelligence. A full scale IQ, verbal IQ and performance IQ are not available.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Using the ICD-10 criteria and additional assessments, Igumnov (1996) showed
that mental disorders among children irradiated in utero resulted from predominantly sociodemographic and socio-cultural factors. An increased prevalence of specific developmental
speech-language and emotional disorders, as well as a lower mean full scale IQ and more
cases of borderline IQ in prenatally exposed children in Belarus were attributed to social
and psychological factors. They did not find any association between prenatal irradiation
and IQ and deterioration of mental health in children (Igumnov, 1999; Kolominsky et al,
1999). This point of view has been supported in the Annex J. Exposures and effects of the
Chernobyl accident. UNSCEAR 2000 report to the General Assembly (2000). It was
concluded that probably a significant role in the genesis of borderline intellectual
functioning and emotional disorders in children exposed in utero in Belarus was due to
unfavourable social-psychological and social-cultural factors (Igumnov & Drozdovitch,
2004).
For children exposed at the age of 0–1.5 years, there are data that show a
correlation between thyroid dose (up to doses of 0.5 Gy) and reduction in intelligence
(Bazyltchik et al, 2001). Average IQ for the subgroup of highly exposed children (thyroid
doses in utero >1 Gy) was lower in comparison with average IQ for the whole exposed
group (Igumnov and Drozdovitch, 2000). Prenatally irradiated children, especially those
exposed at 8–15 weeks, had more functional and organic disorders of CNS, and exhibited
borderline IQ and abnormal EEG linked to both radiation and psychosocial factors (Gayduk
et al, 1994). Children irradiated in utero had the highest indices of mental morbidity and
were more likely to display borderline intelligence and mental retardation that were linked
to prenatal irradiation (Ermolina et al, 1996). The thyroid-stimulating hormone (TSH) level
grows with foetal thyroid dose increase with the 0.3 Sv threshold. The radiation-induced
malfunction of the thyroid-pituitary system was proposed as one important biological
mechanism in the genesis of mental disorders in prenatally irradiated children (Nyagu et al,
1996a,b, 1998). It was hypothesized that malfunction of the left hemisphere limbic-reticular
structures and the left hemisphere is more vulnerable to prenatal irradiation than the right
(Loganovskaja and Loganovsky, 1999). The following were observed in prenatally exposed
group; IQ performance/verbal discrepancies with verbal decrements; a higher frequency of
low-voltage and epileptiformal EEG-patterns and left hemisphere lateralised dysfunction;
an increase (p<0.001) of δ- and β-power and a decrease (p<0.001) of α- and θ-power; an
increased frequency of paroxysmal and organic mental disorders, somatoform autonomic
dysfunction, disorders of psychological development and behavioural and emotional
disorders. Cerebral dysfunction was etiologically heterogeneous (Nyagu et al, 2002a).
Since possible dose correlations were not investigated and contradictory results of
the mental health assessment of the in utero exposed children and the etiology of the
observed neuropsychiatric disorders were found, a thorough study within the framework of
Project 3 «Health Effects on the Chernobyl Accident» of the Franco-German Initiative for
Chernobyl on potential effects of prenatal irradiation on the brain as a result of the
Chernobyl accident has been carried out.
Neuro-psychiatric effects
It should be stressed that currently available data on radiation neuro-psychiatric effects in
the Report of the UN Chernobyl Forum EGH, Working Draft, August 31, 2005 are still
insufficiently presented, despite our constant, numerous on-line additions from the
evidence-based medicine studies.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Irradiation in infancy and childhood
It has become increasingly clear that CNS radiotherapy in infancy and childhood may have
serious long-term effects on cognition and endocrine function. As the treatment of
childhood cancer has improved, long-term survival has become more common (Anderson,
2003). Currently, it is still assumed that the lowest dose on the brain that could be
associated with late deterministic effects of childhood irradiation is 18 Gy, followed by
disorders of cognitive functions, histo-pathological changes and neuro-endocrine effects
(UNSCEAR 1993).
At the same time, evidence of delayed radiation brain damage was revealed 20
years after childhood scalp irradiation in average doses on the brain of only 1.3 Gy in a
cohort of nearly 20,000 Israel children exposed to X-ray irradiation to the head for
ringworm (tinea capitis) management (Yaar et al., 1980, 1982; Ron et al., 1982).
Recently, the effect of low doses of ionizing radiation (>100 mGy) in infancy
(radiotherapy of cutaneous haemangioma) on cognitive function in adulthood has been
proven on the basis of a Swedish population-based cohort study (Hall et al, 2004).
An increased risk of schizophrenia and related disorders was clearly seen among
survivors who had been treated with radiotherapy for brain tumors in childhood or
adolescence, as was shown in a nationwide, population-based, retrospective cohort study in
Denmark (Ross et al, 2003).
Thus, radiation exposure in infancy and childhood is obviously associated with
dose-related cognitive decline in adulthood. The possible dose thresholds of delayed
radiation brain damage are doses as low as 0.1–1.3 Gy to the brain in infancy and
childhood. However, the lowest fraction and total doses on the brain causing
neurocognitive effects are still assumed to be 2 Gy and 18 Gy, correspondingly. Evidently
further studies have to be done for reassessment of the risk-benefit of long-term
consequences of cranial radiotherapy in infancy and childhood. Intellectual development is
adversely affected when the infant brain is exposed to ionising radiation at doses (100
mGy) equivalent to those from computed tomography of the skull (120 mGy). The risk and
benefits of computed tomography should be reassessed (Hall et al., 2004).
Adult irradiation
Some deterministic radiation effects, which result in dysfunction of organs or tissue, are
due not only to cell death. The dysfunction can be the result of interactions with functions
of other tissues. Such «functional deterministic effects», in particular, include changes of
electro-encephalogram (EEG) and retinogram, as well as vascular reactions. These effects
can have significant clinical consequences, particularly in the nervous system (ICRP
Publication 60, 1991). In spite of the fact that the mature CNS is commonly considered to
be extremely radio-resistant, evidence is dramatically increasing in support of the
exceptional radio-sensitivity of the brain (Nyagu and Loganovsky, 1998).
It is accepted in medical radiology that morphological radiation injuries of the
CNS could arise following local brain irradiation by doses more than 10–50 Gy. Radiation
brain necrosis was observed in local brain exposure to 70 Gy and more, where the
development of radiogenic dementia is considered possible. The tolerant dose on the brain
was assumed to be 55–65 Gy, and the tolerant fractional dose — 2 Gy (Gus’kova and
Shakirova, 1989; Gutin et al, 1991; Mettler and Upton, 1995). Primary CNS damage
following total body irradiation were assumed to be at exposure to >100 Gy (the cerebral
form of Acute Radiation Sickness [ARS]), secondary radiation CNS damage — 50–100 Gy
(the toxemic form of ARS) (Gus’kova and Bisogolov, 1971). The threshold of radiationinduced neuro-anatomic changes was assumed to be at the level of 2–4 Gy of whole body
irradiation (Gus’kova and Shakirova, 1989).
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
However, in experimental studies, morphological changes of neurons were revealed as low
as 0.25–1 Gy of total irradiation (Alexandrovskaja, 1959; Shabadash, 1964), and the dose
of 0.5 Gy has been recognized to be the threshold of radiation injury of the CNS with
primary neuronal damages (Lebedinsky and Nakhilnitzkaja, 1960). Persistent changes in
brain bio-electrical activity occur at thresholds of 0.3 to 1 Gy and increase with the dose
absorbed (Trocherie et al., 1984). These data suggest that alteration in CNS functioning is
likely to occur after relatively low doses of radiation (Mickley, 1987). It was shown that
exposure to ionizing radiation significantly modifies neurotransmission (Kimeldorf and
Hunt, 1965) and resulted in multiple effects on the brain and behaviour, depending largely
on the dose received (Hunt, 1987). Ionizing radiation influences upon CNS function and
behaviour as a result of both a direct effect to the nervous system and an indirect effect
through CNS reactivity on the radiation damage of other systems (Kimeldorf and Hunt,
1965; Mickley, 1987). Slowly progressive CNS radiation sickness has been identified
following a single exposure to total irradiation of 1–6 Gy (Moscalev, 1991). In the
UNSCEAR Report (1982) it was noted that after exposure to 1–6 Gy a slow, progressive
degeneration of the brain cortex develops (Vasculescu et al, 1973).
In the Adult Health Study in Hiroshima, atomic bomb radiation doses did not
show any significant association with vascular dementia or Alzheimer’s disease detected 25
to 30 years later. Risk factors for dementia were age, higher systolic blood pressure, history
of stroke, history of hypertension, history of head trauma, lower milk intake and lower
education (Yamada et al, 1999, 2003). However, taking into account that increased blood
pressure was the main contributor to vascular dementia (Yamada et al, 1999), it is
important that in the same Adult Health Study the statistically significant effect of ionizing
radiation on the longitudinal trends of both systolic and diastolic blood pressure was
recently found. This phenomenon is compatible with the degenerative effect of ionizing
radiation on blood vessels (Sasaki et al, 2002). The recent analyses strengthen earlier
findings of a statistically significant increase in non-cancer disease death rates with atomic
bomb radiation dose. In particular, increasing trends are observed for diseases of the
circulatory systems (Shimizu et al, 1999). There is direct evidence of radiation effects for
doses more than 0.5 Sv for heart disease, stroke, digestive diseases and respiratory diseases
(Preston et al., 2003).
Epidemiological studies of atomic bomb survivors have suggested dose-related
increases in mortality from diseases other than cancer. Cardiovascular disease is one such
non-cancer disease for which increases in both mortality and incidence have been found to
be associated with radiation dose (Kusunoki et al., 1999). The recognition in the atomicbomb survivors of non-cancer effects at doses on the order of 0.5 Sv (half the dose level
considered a threshold in earlier studies) should stimulate interest in deterministic effects
(Shimuzu et al., 1999; Fry, 2001; Preston et al., 2003; Yamada et al., 2004) and non-cancer
morbidity and mortality following the Chernobyl accident. It was indicated that the atomic
bomb exposure has affected survivors' mental health and that the care of their mental health
is important (Honda et al., 2002). The prevalence of anxiety symptoms and somatization
symptoms was elevated in atomic bomb survivors even 17-20 years after the bombings had
occurred, indicating the long-term nature of the psychiatric effects of the experience
(Yamada and Izumi, 2002). However, these studies were related to neurotic symptoms only
— anxiety and somatization. At the same time, the linkage of The Life Span Study (LSS)
and the schizophrenia register in the Department of Neuropsychiatry, University School of
Medicine, Nagasaki revealed that the prevalence rate of schizophrenia in A-bomb survivors
is very high — 6% (Nakane and Ohta, 1986).
Current estimates of lifetime prevalence of schizophrenia vary from 0.9–6.4 and
an estimate of the mean prevalence is 1.4–4.6 per 1.000 (Jablensky, 2000). Included within
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
the framework of the WHO 10-country study (Jablensky et al, 1992), the incidence of
schizophrenia in Honolulu (USA) was 1.5 and in India 4.1 per 10.000 population (McGrath
et al, 2004). The incidence of schizophrenia in India was the highest world-wide and this
could not be explained solely by the level of psychiatric care (Tsirkin, 1987). In India there
are areas of high natural radiation background due to monazite sands in Kerala, Madras,
and the Ganges delta resulting in high average absorbed dose rate in the air of 1,800 nGy⋅h–
1
(UNSCEAR 2000). The coastal belt of the Trivandrum and Quilon districts of Kerala has
a very high natural radioactivity — over 15 mSv per year (Rajendran et al., 1992).
Worldwide annual exposures to natural radiation sources would generally be expected to be
in the range 1–10 mSv, with 2.4 mSv being the present estimate of the central value
(UNSCEAR 2000).
Since 1990, there has been a significant increase in schizophrenia incidence in the
Chernobyl exclusion zone personnel (clean-up workers) compared to the general population
(5.4 per 10,000 in the EZ versus 1.1 per 10,000 in the Ukraine in 1990) (Loganovsky and
Loganovskaja, 2000).
Immediately after the Chernobyl accident autonomic [vegetative] vascular
dystonia (VVD) and neurotic disorders were observed in the clinical picture of mild ARS
[or ARS of the 1st severity degree] (0.8–2.1 Gy); moderate ARS [or ARS of the 2nd severity
degree] (2–4 Gy) — VVD; severe ARS [or ARS of the 3rd severity degree] (4.2–6.3 Gy) —
acute radiation and radiation-toxic encephalopathy, acute psychosis with visual and
acoustical hallucinations, brain edema; very severe to lethal ARS [or ARS of the 4th
severity degree] (6–16 Gy) — acute radiation and radiation-toxic encephalopathy,
subarachnoidal-parenchimatous hemorrhage, acute brain edema and swelling (Torubarov et
al, 1989).
No clear signs of organic brain damage were registered during the first 3 years
after irradiation in ARS-survivors. Mental working capacity deterioration and asthenisation
were in proportion to the severity of ARS. The vegeto-vascular and vegeto-visceral stage of
neuropsychiatric pathology (3–5 years after irradiation) changes with cerebral organic and
somatogenous pathology (>5 years after irradiation) (Nyagu et al, 1996c, 2002b).
Neuropsychiatric and neuropsychophysiological follow-up studies confirm that ARSpatients show progressive structural-functional brain damage: post-radiation
encephalopathy [postradiation organic brain syndrome]. Even a considerable period of time
after exposure quantitative EEG allows a distinction between confirmed and non-confirmed
ARS (Nyagu et al, 2002b; Loganovsky, 2002).
The EEG-patterns and topographical distribution of spontaneous and evoked brain
bioelectrical activity in overexposed liquidators, especially long-term workers of the
Chernobyl zone, differed significantly from the control and comparison groups (Nyagu et
al, 1992, 1999; Noshchenko and Loganovskii, 1994; Loganovsky, 2000). There were many
consistent reports concerning characteristic neurophysiological disorders (Danilov and
Pozdeev, 1994; Zhavoronkova et al, 1994, 1995a,b, 1998; Vyatleva et al, 1997),
neuropsychological (Khomskaja, 1995; Zhavoronkova et al, 1996, 2000), and
neuroimaging (Zhavoronkova et al, 1994; Kharchenko et al, 1995; Kholodova et al, 1996;
Voloshina, 1997) abnormalities in liquidators, supporting clinical data about organic brain
damage (Chuprikov et al, 1992; Krasnov et al, 1993; Romodanov and Vynnyts’kyj, 1993;
Napreyenko and Loganovsky, 1995, 1997, 1999, 2001a,b; Nyagu and Loganovsky, 1998;
Revenok, 1998, 1999; Zozulya et al, 1998; Morozov and Kryzhanovskaja, 1998; Lysyanyj,
1998).
The progressive character of neuropsychiatric disorders and somatic pathology is
observed in liquidatiors exposed between 1986-1987, especially in those who worked for 35 years within the Chernobyl exclusion zone. A prevalence of neuropsychiatric disorders
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
was observed among personnel working between 1986-1987 and irradiated in doses above
250 mSv of 80.5% while, for the same contingency, but irradiated in doses below 250 mSv
– 21.4% (p<0.001) (Bebeshko et al, 2001; Nyagu et al, 2003). Personnel who have been
working within the Chernobyl exclusion zone since 1986 are the group at highest risk of
neuropsychiatric disorders, where organic, including symptomatic, mental disorders (F00—
F09) dominate (Loganovsky, 1999). Those irradiated by moderate to high doses (more than
0.3 Sv), including ARS patients, had significantly more left fronto-temporal limbic
dysfunction and schizophreniform syndromes (Loganovsky, 2000a; Loganovsky and
Loganovskaja 2000). Among a considerable part of the personnel, especially those who
carried on with their work into the 1990-s, the pathology revealed met the criteria of
Chronic Fatigue Syndrome (CFS). A hypothesis was suggested concerning development of
CFS under impact of low and very low doses combined with psychological stress
(Loganovsky et al, 1999, Loganovsky, 2000b).
These findings should be confirmed by international collaborative studies.
Moreover, the biological basis of the relationships should be revealed.
Suicides
As was presented at the Report of the UN Chernobyl Forum EGH, suicide was the leading
cause of death among Estonian clean-up workers (Rahu et al, 1997). Age-adjusted
mortality from suicide rates were higher among the Chernobyl clean-up workers compared
to the general population in Lithuania (Kesminiene et al, 1997). These findings have to be
replicated in studies of clean-up workers from other countries using standardized
methodology for suicides due to possible misclassification of them as another cause of
death.
Summary
It is true, as outlined in the Report of the UN Chernobyl Forum EGH, that the context in
which the Chernobyl accident occurred, i.e., the complicated series of stressful events
unleashed by the accident, the self-fulfilling consequences of the official label «Chernobyl
victim» given to the affected population, the multiple stress factors that occurred in the
former Soviet Union before and after Chernobyl and the culture-specific ways of
expressing distress, makes the findings difficult to interpret precisely.
At the same time, an increasing pool of data on radiation cerebral effects cannot be
ignored. This concerns;
• Non-cancer effects in atomic-bomb survivors at doses of 0.5 Sv (Shimuzu et
al, 1999; Preston et al, 2003);
• Epidemiological evidences on dose-related cognitive decline following
radiotherapy in childhood with possible dose thresholds of delayed radiation
brain damage at doses as low as 0.1–1.3 Gy on the brain (Yaar et al, 1980,
1982; Ron et al, 1982; Hall et al, 2004);
• Cognitive and emotional-behavioral disorders (WHO, 1996; Nyagu et al,
1998, 2002a; Kolominsky et al, 1999; Loganovskaja and Loganovsky, 1999;
Igumnov and Drozdovitch, 2000), and neurophysiological abnormalities
(Nyagu et al, 1996a,b, 1998, 2002a; Loganovskaja and Loganovsky, 1999) in
prenatally exposed children;
• Postradiation organic brain syndrome in ARS-patients (Nyagu et al, 2002b;
Loganovsky, 2002) and characteristic neurophysiological, neuropsychological
and neuroimaging abnormalities in liquidators, supports clinical
neuropsychiatric data about organic brain damage where, following exposure
from moderate to high doses (more than 0.3 Sv) left fronto-temporal limbic
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•
•
•
dysfunction and schizophreniform syndromes dominate (Loganovsky, 2000a,
2002; Loganovsky and Loganovskaja, 2000);
Schizophrenia and related disorders (Nakane and Ohta, 1986; Imamura et al,
1999; Loganovsky and Loganovskaja, 2000);
Сhronic Fatigue Syndrome following exposure to low and very low doses
combined with psychological stress (Loganovsky et al, 1999, Loganovsky,
2000b).
Obviously, these effects associated with exposure to ionizing radiation have to
be confirmed by international collaborative studies. Moreover, their biological
basis should be elucidated.
Current status of evidence
Potential prenatal cerebral effects
Extrapolation of the Japanese data to the situation after the Chernobyl accident is quite
difficult. Thus, the Chernobyl accident caused significantly lower foetal doses, but
significantly much higher doses on the foetal thyroid by the incorporation of radioiodine
released by the burning reactor. Whereas after the Chernobyl accident the population was
continuously exposed to radionuclides, mainly of radioiodine and 137Cs, the Japanese
population was acutely irradiated by γ-rays and neutrons. There was no separate radioiodine
exposure of the thyroid in Japan. Because of the different radiobiological situations, it is not
easy to predict the radiobiological effect of the Chernobyl accident from the results of the
Japanese studies (Nyagu et al, 2004b).
Due to the contradictory results of the mental health assessments of the children
exposed in utero and the etiology of the observed neuropsychiatric disorders in the
literature, a thorough study of the potential radiation effects on the mental health of the in
utero exposed children was performed within the framework of Project 3 «Health Effects
on the Chernobyl Accident» of the French-German Initiative for Chernobyl. A cohort of
154 children born between April 26th, 1986 and February 26th, 1987 to mothers who had
been evacuated from Pripyat to Kiev, and 143 classmates from Kiev were examined with
the Wechsler Intelligence Scale for Children (WISC) and the Achenbach and Rutter A(2)
tests. Mothers were tested for their verbal abilities (WAIS), depression, anxiety and
somatization (SDS, PTSD, GHQ 28). Individual dose reconstruction of the children was
carried out taking into account internal and external exposure. The ICRP Publication-88
was applied for calculation of effective foetal, brain and thyroid internal doses for children
of both groups. There were 52 children from Pripyat (33.8%) who had been exposed in
utero to equivalent thyroid doses >1 Sv, 20 of these children 13.2% had been exposed in
utero to fetal doses >100 mSv. The prenatally exposed children showed significantly more
mental disorders and diseases of the nervous system. Exposed children showed lower fullscale IQ due to lower verbal IQ and therefore an increased frequency of performance/verbal
intelligence discrepancies. When IQ discrepancies of the prenatally irradiated children
exceeded 25 points, there appeared to be a correlation with the foetal dose. The exposed
and control mothers did not show differences in verbal abilities, but they had experienced
many more real stress events and suffered from severer depression, PTSD, somatoform
disorders, anxiety/insomnia and social dysfunctions than the control mothers from Kiev
(Nyagu et al, 2004a,b,c).
A radio-neuro-embriological effect — intelligence disharmony due to verbal IQ
deterioration — has been revealed following the radiation accident at the nuclear reactor at
8–15 and later weeks of gestation, fetal >20 mSv and thyroid doses in utero >300 mSv.
Spectral θ-power decreased (particularly, in the left fronto-temporal area), β-activity
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increased together with its lateralization towards the dominant hemisphere, disorders of
normal inter-hemispheric asymmetry of visual evoked potentials and the vertex-potential
can be considered as neurophysiological markers of prenatal exposure. The most critical
period of cerebrogenesis occurs during the later terms of gestation (16–25 weeks). The
radiation accident on the nuclear reactor resulted in a release of radioactive iodine into the
environment and this had a greater effect on cerebrogenesis than the uniform external
exposure (Loganovskaja and Nechayev 2004; Loganovskaja, 2004, 2005). The frequency of
mental disorders and personality disorders due to brain injury or dysfunction — F06, F07;
disorders of psychological development — F80–F89; paroxysmal states (headache
syndromes — G44, migraine — G43, epileptiform syndromes — G40); somatoform
autonomous dysfunction — F45.3; behavioral and emotional disorders of childhood —
F90–F99 were increased among these children (Napreyenko and Loganovskaja, 2004;
Loganovskaja, 2005).
A follow-up study is currently underway, funded by the United States National
Institute of Health (NIH), to examine the health and mental health of a cohort of 18-19 year
olds who were in utero–15 months old when the accident occurred and aged 11 at the time
of first assessment. The study addresses the extent to which initial perceptions of the event
are risk factors for future mental health, as well as the differences at age 18 between
exposed children and their mothers versus the original classmate control group in Kiev and
a new population-based control group from other unaffected urban areas in Ukraine.
Population studies
It was concluded that epidemiological data do not at present provide clear
evidence of a risk of circulatory diseases at doses of ionizing radiation in the range 0-4 Sv,
as suggested by the atomic bomb survivors. Further evidence is needed to characterize the
possible risk (McGale and Darby, 2005).
Within the framework of the Franco-German Chernobyl Initiative sub-project
3.8.1 «Data base on psychological disorders in the Ukrainian liquidators of the Chernobyl
accident» A cross-sectional study of a representative cohort of liquidators, using a
standardized structured psychiatric interview — Composite International Diagnostic
Interview (CIDI), was carried out. The preliminary results have been revealed (Romanenko
et al, 2004): a two-fold increase in the prevalence of mental disorders (36%) in liquidators
in comparison with the Ukrainian general population (20.5%); a dramatic increase in the
prevalence of depression (24.5%) in liquidators in comparison with the Ukrainian general
population (9.1%) (Demyttenaere et al, 2004). The dataset is open to analysis. However,
the limitation of this study is the assessment of psychological disorders only. It excludes
severe mental disorders.
Compared with controls, the evacuees reported significantly more health problems
and rated their health more poorly overall. The relationship between Chernobyl stress and
illness was twice as strong in evacuees (odds ratio = 6.95) as in Kiev controls (odds ratio =
3.34) and weakest in the national sample (odds ratio = 1.64). The results confirm the
persistence and nonspecificity of the subjective medical consequences of Chernobyl and are
consistent with the hypothesis that traumatic events exert their greatest negative impacts on
health in vulnerable or disadvantaged groups (Adams et al, 2002; Bromet et al, 2002).
The progressive character of neuropsychiatric disorders and somatic pathology is
observed in the liquidatiors of 1986-1987, especially in those who worked for 3-5 years
within the Chernobyl exclusion zone. Prevalence of neuropsychiatric disorders among
personnel working since 1986-1987 and irradiated in doses above 250 mSv is 80.5%, while
for the same contingency but irradiated in doses below 250 mSv – 21.4% (p<0.001) (Nyagu
et al, 2003).
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It has been revealed that since 1990 there has been an increase in the incidence rate of
schizophrenia in the personnel compared with the general population: 5,4 per 10.000 vs. 1,1
per 10,000 correspondingly. Relative risks are 2,4 in 1986—97 and 3,4 in 1990—97,
testifying to an association between working and living in the Chernobyl exclusion zone
and an increase in the schizophrenia incidence rate by 2,4—3,4 times in comparison with
the general population.
A significant increase has also been established of schizophrenia percentage
among all psychoses among the Chernobyl exclusion zone staff members in comparison
with the general population. Moreover, a non-typical clinical form of schizophrenia was
revealed in the personnel who had been working since 1986—87. Those irradiated by
moderate to high doses (more than 0.3 Sv) had significantly more left fronto-temporal
limbic and schizophreniform syndromes. It has been hypothesized that ionizing radiation
may be an environmental trigger that can actualize a predisposition to schizophrenia or
indeed cause schizophrenia-like disorders (Loganovsky and Loganovskaja, 2000). An
integration of international efforts to discuss and organize collaborative studies in this field
is of significance for both clinical medicine and neuroscience (Loganovsky et al, 2005)
In the Chernobyl accident clean-up workers (liquidators) the non-cancer effects of radiation
risks has been revealed (Biriukov et al, 2001; Buzunov et al, 2001, 2003). For some classes
of non-cancer diseases among liquidators, statistically significant estimates of radiation risk
were derived for the first time: mental disorders — ERR 1/Gy=0.4 (0.17; 0.64);
neurological and sensory disorders — ERR 1/Gy=0.35 (0.19; 0.52); endocrine disorders —
ERR 1/Gy=0.58 (0.3; 0.87). Among mental disorders the higher radiation risks were
revealed for neurotic disorders— ERR =0.82 (0.32; 1.32) (Biriukov et al, 2001). The
highest excess relative risk per 1 Gy was found for cerebrovascular diseases — ERR
1/Gy=1.17 at the 95% confidence interval (0.45; 1.88) (Ivanov et al, 2000). Recently, the
significant risk of cerebrovascular diseases from an average dose rate was defined for
external doses greater then 150 mGy (ERR for 100 mGy/day = 2.17, with 95% CI = (0.64;
3.69) (Ivanov et al, 2005).
According to the data from the State Register of Ukraine and the Clinical and
Epidemiological Registry (Scientific Centre for Radiation Medicine, Kiev) there is an
increased level of cerebrovascular disorders in liquidators and evacuees. Exposure to small
doses of ionizing radiation is a significant risk factor of accelerating ageing. Thyroid
exposure by 300 mGy and more is a significant risk factor for vascular and cerebrovascular
disorders. Thyroid exposure by 2 Gy or more is a significant risk factor for mental
disorders, vascular and cerebrovascular diseases, and the peripheral nervous system.
Exposure to dose 250 mGy or more is a significant risk factor for neuropsychiatric
disorders and vascular disorders. There is a dose–effect relationship for cerebrovascular
disorders in liquidators. Relative risk of cerebrovascular diseases is increased in the groups
exposed to 0.5–0.99 Gy and 1 Gy in comparison with the group of <0.1 Gy. Non-radiation
risk factors for neuropsychiatric pathology (cerebrovascular) includes: industrial hazards,
stress, smoking, heredity and life style (Buzunov et al, 2001, 2003).
However, concerning the mental health assessment of liquidators, these studies
have significant limitations: they deal with mental disorders registered by the national
health care system, but not with the data obtained as a result of well-designed psychiatric
studies with standardized diagnostic procedure. Taking into account also the current
changes of the psychiatric system in the post-soviet countries, this leads to a dramatic
underestimation of mental disorders and their possible misclassification as physical
diseases and/or wrong diagnoses of mental disorder itself (neurotic as opposed to actually
psychotic or organic, etc.).
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For example, according to the official Public Health Ministry of Ukraine data, the
prevalence of all mental disorders (registered) in the Ukrainian population consisted: in
1990 — 2.27%; in 1995 — 2.27%, and in 2000 — 2.43%. However, according to the
results of the World Health Organization (WHO) World Mental Health (WMH) Survey
Initiative, where they assessed mental disorders with the WMH version of the WHO
Composite International Diagnostic Interview (WMH-CIDI), a fully structured, layadministered psychiatric diagnostic interview, the prevalence of having any WMHCIDI/DSM-IV disorder in the prior year in Ukraine was 20.5% (95% CI —17.7–23.3%)
(Demyttenaere et al, 2004). So, the public health psychiatric system underestimates mental
disorders by at least 10 times. It should be stressed, that the WMH-CIDI/DSM-IV disorders
included so-called psychological disorders (anxiety, depression, somatization, alcohol
abuse, etc.) only and did not deal with severe mental disorders — psychoses, organic
mental disorders, and mental retardation.
Neuropsychiatric effects
A prospective conventional EEG study was carried out 3-5 and 10-13 years after the
Chernobyl accident in patients who had ARS and in liquidators of 1986. Control groups
comprised healthy volunteers; veterans of the Afghanistan war with post-traumatic stress
disorder; veterans with mild traumatic brain injury; and patients with dyscirculatory
encephalopathy. Within 3-5 years after irradiation, there were irritated EEG changes with
paroxysmal activity shifting to the left fronto-temporal region (cortical-limbic over
activation) that were transformed 10-13 years after irradiation toward a low-voltage EEG
pattern with excess of fast (beta) and slow (delta) activity together with depression of alpha
and theta activity (organic brain damage with inhibition of the cortical-limbic system)
(Loganovsky and Yuryev, 2001).
Cross-sectional quantitative electroencephalogram (qEEG) studies (1996-2001)
among Chernobyl accident survivors, who had confirmed ARS and were irradiated in doses
of 1-5 Gy, revealed the neurophysiological markers of ionizing radiation.
Neurophysiological markers were: left fronto-temporal dominant frequency reduction;
absolute delta-power lateralization to the left (dominant) hemisphere; relative delta-power
increase in the fronto-temporal areas; absolute theta-power decrease in the left temporal
region; absolute and relative alpha-power diffusive decrease, which may reflect corticolimbic dysfunction lateralized to the left, dominant hemisphere, with the fronto-temporal
cortical and hippocampal damage. Quantitative electroencephalogram proposed for
differentiation of radiation and nonradiation brain damages and as a new biological
dosymetry method. High radiosensitivity of the brain, neocortex, and dominant hemisphere
higher radiosensitivity are discussed. (Loganovsky and Yuryev, 2004).
Changes in brain asymmetry and inter-hemispheric interaction can be not only a
result of a dysfunction of subcortical limbic-reticular and mediobasal brain structures but
also a result of the white matter damage including corpus callosum (Zhavoronkova et al,
2000). The EEG findings suggest subcortical disorders at different levels (diencephalic or
brainstem) and functional failure of the right or left hemispheres in remote terms after
exposure to radiation (Zhavoronkova et al, 2003).
A 4-year longitudinal study of the cognitive effects of the Chernobyl nuclear
accident was conducted from 1995 to 1998. The controls were healthy Ukrainians residing
several hundred kilometers away from Chernobyl. The exposed groups included
liquidators, Forestry workers and Agricultural workers living within 150 km of Chernobyl.
Accuracy and efficiency of cognitive performance were assessed using ANAMUKR, a
specialized subset of the Automated Neuropsychological Assessment Metrics (ANAM)
battery of tests. Analyses of variance, followed by appropriate pair-wise comparisons,
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
indicated that the 4-year average levels of performance of the exposure groups (especially
the liquidators) were significantly lower than those of the controls in most measures; further
analyses of performance across time revealed significant declines in accuracy and
efficiency, as well as psychomotor slowing, for all exposed groups over the 4-year period.
These findings strongly indicate impairment of brain function resulting from both acute and
chronic exposure to ionizing radiation (Gamache et al, 2005).
The neural diathesis-stressor hypothesis of schizophrenia, where neurobiological
genetic predisposition to schizophrenia can be provoked by environmental stressors is
considered as a model of the effects of exposure to ionizing radiation. There are comparable
reports on increases in schizophrenia spectrum disorders following exposure to ionizing
radiation as a result of atomic bombing, nuclear weapons testing, the Chernobyl accident,
environmental contamination by radioactive waste, radiotherapy, as well as in areas with
high natural radioactive background (Loganovsky et al., 2004a, 2005a). The results of
experimental radioneurobiological studies support the hypothesis of schizophrenia as a
neurodegenerative disease (Korr et al, 2001; Gelowitz et al, 2002; Schindler et al, 2002).
Exposure to ionizing radiation causes brain damage with cortical-limbic system dysfunction
and impairment of informative processes at the molecular level that can trigger
schizophrenia in predisposed individuals or cause schizophrenia-like disorders
(Loganovsky et al., 2004a, 2005a).
Negative psychopathological symptoms increase in proportion to the radiation
dose (at doses >0.3 Sv), but symptoms of PTSD has an inverse relationship to the dose.
Depression is more pronounced among the patients who had the severest ARS. After
irradiation at doses >0.3 Sv and, especially after ARS (>1 Sv), there are a predominant
involvement of the fronto-temporal regions of the dominating (left) hemisphere; EEG
slowing; progressive decreasing of absolute spectral power («flat» low-voltage EEG) with
increased δ- and β-power and decreased θ- and α-power. Apathetic-abulic endoformous
organic brain syndrome prevails in liquidators exposed to 0.3–0.5 Sv and more while
cerebrasthenic syndrome or cerebrasthenic and dysthymic variants of organic brain
syndrome predominate at less 0.3 Sv. The relationship between neurophysiological effects
and radiation dose was revealed only in doses more than 0.3 Sv - that proposed as the
threshold of these effects. This dependence is significantly intensified in long-term work
(more than 5 years) within the Chernobyl exclusion zone (Loganovsky, 2000a, 2002).
Post-radiation organic brain syndrome has been diagnosed in 62% of patients who
had confirmed ARS. The apathetic type of organic personality disorder (F07.0) is a
characteristic for ARS after effects. It has a progressive clinical course and correlates with
the severity of ARS or the dose (Loganovsky, 2002; Loganovsky et al., 2005b). Organic
brain damage, long after ARS, has been verified by clinical neuropsychiatric,
neurophysiolocial, neuropsychological and neuroimaging methods (Loganovsky et al,
2003; 2005b).
There are neuropsychological dose-effects relationships in humans at 0.5-5 Sv
dose range — dysfunction of memory interferention (r=0.6); dysfunction of associations
(r=0.68), and dysfunction of senso-motor coordination (r=0.8) (Antipchuk, 2004, 2005).
The cerebral effects, long after irradiation, are a pathology of frontal and temporal cortex of
the dominant hemisphere and middle structures with their cortical-sub-cortical connections,
resulting in higher mental activity deterioration in structural, organic and psychical
disorders (Antipchuk, 2001, 2003, 2005). At the same time, memory, acoustic-perceptual
and, partially, thinking functions were most vulnerable for liquidators exposed below 0.35
Sv (Turuspekova, 2002). Dose—effect relationship on mental working capacity
deterioration was revealed for the ARS patients (>1 Sv) (Zdorenko and Loganovsky, 2002).
The reduction of verbal and full IQ in comparison with controls, as well as IQ deterioration
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
according to pre-exposure IQ estimates, are evidence of organic brain syndrome (with
paramount involvement of the left, dominating, hemisphere) following ARS (Loganovsky
and Zdorenko, 2004).
In spite of the fact that the CNS is commonly considered to be extremely
radioresistant, evidence is dramatically increasing in support of the exceptional
radiosensitivity of the brain. There is the «dose–effect» relationship between the dose and
the characteristic morphometric neuroimaging features of organic brain damage, starting
with 0.3 Sv and increasing in proportion to the dose. There is the neuroimaging dose-effects
relationship in humans by brain MRI considered to be neuroimaging radiation markers.
They are at 1–5 Sv: contrast index of left internal capsule (r=-0.86) and contrast index of
white matter of left parietal lobe (r=-0.41); the markers at 0.3–5 Sv: contrast index of left
internal capsule (r=-0.3). These data testify to radiation-induced organic brain damage
among over-exposed Chernobyl accident victims and support the presence of radiation risks
for the brain as well as high radiosensitivity of the brain (Bomko, 2004a, 2005). Cortical
atrophy of cerebral hemispheres and damage of neuronal pathways in the dominant
hemisphere are the characteristic morphometric neuroimaging features of organic brain
damage to ionizing radiation as a result of the Chernobyl accident (Bomko, 2004b, 2005).
Brain damage following earlier exposure to irradiation as a result of the Chernobyl
accident has characteristic patterns testifying to organic damage of gray and white brain
matter of atrophic genesis with predominant involvement of the frontal and temporal lobes,
particularly, of the left (dominating) hemisphere (Loganovsky et al, 2004b). The structuralfunctional pattern of radiation-induced organic brain damage in Chernobyl accident cleanup workers consists in the pathology of cerebral cortex, subcortical structures, neuronal
pathways and cortical-limbic system of the left (predominantly) cerebral hemisphere.
Associations between neurophysiological and neuroimaging parameters and dose make
dose reconstruction possible using parameters of cEEG and brain MRI long after exposure
to ionizing radiation (Loganovsky and Bomko, 2004).
Radiation accelerated aging might be a model of senescence and
neurodegeneration in humans. Prospective epidemiological studies of atomic bomb
survivors revealed ionizing radiation significantly increased mortality for causes other than
cancer. Results do not support claims that survivors exposed to low doses live longer than
comparable unexposed individuals. Whether exposure to a low dose is a risk factor for
accelerated aging and neurodegeneration is still unanswered and the biological mechanisms
involved unknown. According to a wide range of scientific data reviewed, the following
hypotheses can be proposed: 1) exposure to low-dose ionizing radiation is a risk factor for
accelerated aging processes and neurodegeneration; 2) aging and neurodegeneration
processes after exposure to ionizing radiation could be enhanced by the synergetic
influence of heterogeneous pathogenetic factors, such as immunological, oxidative stress
and molecular-genetic changes (Bazyka et al, 2004).
From 100 randomly selected clean up workers who were involved with the
Chernobyl accident 26% met the CFS diagnostic criteria. Their absorbed doses were less
0.3 Sv, which could not produce any clear deterministic radiation effect. A psychophysiological basis for fatigue in liquidators is dysfunction of the cortico-limbical structures
of the left, dominating, hemisphere. CFS is one of the most significant consequences of
radio-ecological disaster resulting in an interaction of different hazardous environmental
factors (Loganovsky, 2000b, 2003). CFS frequency significantly (p<0,001) decreased (from
65,5% in 1990–1995 to 10,5% in 1996–2001) and Metabolic Syndrome X (MSX)
frequency significantly (p<0,001) increased (from 15 to 48,2%). CFS and MSX are
considered to be early stages of other neuropsychiatric and physical pathology
development, and CFS can transform towards MSX. Radiation-induced damage of
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
mitochondrial DNA in post-mitotic tissues with low proliferation activity may be one of the
effects of low doses contributing to an increase in non-cancer morbidity and mortality in
the Chernobyl accident survivors (Kovalenko and Loganovsky 2001). CFS can be
considered an environmentally induced predisposition and precursor of forthcoming
neurodegeneration, cognitive impairment, and neuropsychiatric disorders. The generalized
conceptual framework unique to the Chernobyl accident data, including clinical, molecular
biomarkers, and different exposure to multiple environmental stress-factors (acute and
chronic exogenous and endogenous (radionuclides) irradiation, chemical agents, viruses,
severe psychological stress, etc) allow us to investigate, conceptualize, and illustrate
fundamental aspects of CFS etiology and pathophysiology and its neurodegeneration and
neuropsychiatric perspectives (Volovik et al, 2005).
Interventions
The attentions of The Radiation Centre for Radiation Medicine (Kiev) were constantly
focused on the improvement of the mental health of the affected population. The lessons to
be learned from the Chernobyl accident experience include;
1) Neuropsychiatric care in the aftermath of ARS and overexposure to ionising
radiation should be a priority area of attention following exposure to accidental
irradiation;
2) Neuropsychiatric treatment should be carried out as early as possible, as with
brain trauma;
3) Limitations should be imposed on duration of work in the Chernobyl exclusion
zone (and similar industries) in order to provide adequate mental health care of
personnel. At the end of this period working staff members should terminate their
work or begin rehabilitation. A 5-years work-limit is recommended;
4) Effective protection of mental health is only possible by simultaneously
addressing the neuropsychiatric, personal, somatic and social spheres of the lives
of the survivors. In this regard, the establishment of a National Service for Mental
Health for the protection of survivors should be a priority;
5) A social measures system is needed;
6) Non-pharmacological interventions;
7) Pharmacological treatment of main and co-morbid pathology;
8) Long-term support and maintenance treatment.
Conclusions
1) Mental disorders are one of the most important medical and social problems facing
Chernobyl accident survivors 20 years after the Chernobyl accident
2) Mental health care of victims should be a focus of public concern following
possible radiation accidents in the future;
3) Mental health impacts on the liquidators of the Chernobyl accident includes:
psychological disorders
organic brain damage
suicides
chronic Fatigue Syndrome
schizophrenia spectrum disorders
accelerated aging processes and neurodegeneration
4) There is a big gap in epidemiological evidence concerning the mental health of
exposed populations, as well as a gap in knowledge about the biological
mechanisms of the effects of low doses on the brain
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
5)
6)
7)
There is a deficiency in mental health care and psycho-rehabilitation for survivors.
According to current knowledge, the potential cerebral effects of radiation could be
outlined as follows:
• Potential cerebral effects of radiation could be realized following exposure
to >0.15–0.5 Sv
• Dose-related cognitive decline following radiotherapy in childhood with
possible dose thresholds of delayed radiation brain damage at doses as low
as 0.1–1.3 Gy on the brain;
• Dose-related cognitive and neurophysiological abnormalities in prenatally
exposed children;
• Postradiation organic brain syndrome in ARS-patients and dose-related
neuropsychiatric,
neurophysiological,
neuropsychological
and
neuroimaging abnormalities following exposure to >0.3 Sv;
Effects on the CNS that could be attributed to exposure of ionizing radiation are as
follows:
• Schizophrenia spectrum disorders;
• Chronic Fatigue Syndrome;
• Accelerated aging processes and neurodegeneration.
Recommendations
1) Further well-designed neuropsychiatric epidemiological studies in Chernobyl
accident survivors should have a priority. An integration of international efforts to discuss
and organize collaborative studies concerning neuropsychiatric disorders, including organic
brain damage, CFS, schizophrenia spectrum disorders, suicides and para-suicides are of great
importance for both clinical medicine and neuroscience.
2) The development of a model which will predict safety levels in the case of
extreme environmental stress factors associated with radiation exposure using the data from
the Chernobyl accident.
3) Neuropsychiatric follow up survey of ARS-patients must be continued for a life
time. In vivo morpho-functional (fMRI; qEEG, EP) and neurochemical studies (SPET) are
of the greatest priority.
4) The study of cerebral effects of prenatal exposure should be continued as
follows; an increase in the size of the cohort; identification of additional children irradiated
in utero and children exposed at the age of 0–1 years; the identification and forming of
cohorts of age-, gender- and urban/rural-matched children from radioactively clean areas of
the Ukraine; the verification and development of the currently available dosimetric models;
the assessment and verification of neuropsychiatric disorders and a full risk analysis should
be carried out on the influence of radioiodine on brain development during the prenatal
period and the 1st year of life.
5) Further clinical and experimental neurophysiological, neurobehavior,
neuroimaging, neurochemical and neuroimmunological studies are of the greatest
importance for brain assessment and radiation risks.
6) Neuropsychiatric care in the aftermath of ARS and overexposure to ionising
radiation should be a priority area of attention and this treatment should be carried out as
early as possible, as with any trauma to the brain;
7) Maximum work duration in the Chernobyl exclusion zone (and similar
industries) should be limited to 5-years;
8) International efforts should be made to improve the mental health care and
psycho-rehabilitation of Chernobyl accident survivors.
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References
Adams RE, Bromet EJ, Panina N, Golovakha E, Goldgaber D, Gluzman S (2002) Stress
and well-being in mothers of young children 11 years after the Chornobyl
nuclear power plant accident. Psychol Med. 32(1):143–156.
Alexandrovskaja MM (1959) Effects of different doses of ionizing radiation on the brain
morphology in animals at total irradiation. Medical Radiology, 4 (8): 79–81 [in
Russian].
Allen PT, Rumyantseva G (1995). The contribution of social and psychological factors to
relative radiation ingestion dose in two Russian towns affected by the Chernobyl
NPP accident. Society for Risk Analysis (Europe), p 1-9
Anderson NE (2003) Late complications in childhood central nervous system tumour
survivors. Curr Opin Neurol, 16(6): 677–683.
Antipchuk YeYu (2001) Disorders of the highest cortical functions in clean-up workers
(1986) of the Chernobyl accident with encephalopathy. In: Problems of
Radiation Medicine, Research Centre for Radiation Medicine of Academy of
Medical Sciences of Ukraine. Kiev, Vol. 8, pp 83–89 [in Russian].
Antipchuk KYu (2003) Memory disorders in persons who had acute radiation sickness as a
result of the Chernobyl accident in remote period. Ukrainian Radiological
Journal, 11: 68–72 [in Ukrainian].
Antipchuk KYu (2004) Neuropsychologic method in diagnostic of radiation brain
disorders. Ukrainian Medical Journal, 3(41): 121–128 [in Ukrainian].
Antipchuk KYu (2005) Clinical-neuropsychological characteristic of organic mental
disorders in remote period of exposure to ionizing radiation as a result of the
Chernobyl accident. The dissertation for the academic degree of a Candidate of
Medical Sciences in radiobiology. Research Centre for Radiation Medicine of
Academy of Medical Sciences of Ukraine. Kiev.
Bar Joseph N, Reisfeld D, Tirosh E, Silman Z, Rennert G. (2004) Neurobehavioral and
cognitive performance in children exposed to low-dose radiation in the
Chernobyl accident: The Israeli Chernobyl Health Effects Study. Am J
Epidemiol, 160, 453-459
Bazyka DA, Volovik SV, Manton KG, Loganovsky KN, Kovalenko AN (2004) Ionizing
radiation accelerating aging and neurodegeneration. International Journal of
Psychophysiology, 54 (1–2): 118–119.
Bazyltchik S, Drozd VM, Reiners Chr, Gavrilin Yu (2001) Intellectual development of
children exposed to radioactive iodine after the Chernobyl accident in utero and
at the age under 1.5 years. In: Abstracts of the 3rd Int. Confer. «Health Effects
of the Chernobyl Accident: Results of 15-year Follow up Studies», Kiev, June
4–8, 2001. International Journal of Radiation Medicine, Special Issue 3 (1–
2):15.
Bebeshko V, Bazyka D, Nyagu A, Loganovsky K, Khomaziuk I, Lyashenko L,
Klymenko V, Chumak A, Los I, Chumak V, Gaevaja L (2001) Radiation
protection and health effects of Chernobyl nuclear power plant staff during the
decommissioning. In: Abstracts of the 2nd International Conference «The Effects
of Low and Very Low Doses of Ionizing Radiation on Human Health», 27–29
June, 2001, Dublin. World Council of Nuclear Workers, p. P6-6.
Biryukov A, Gorsky A, Ivanov S, Ivanov V, Maksioutov M, Meskikh N, Pitkevitch V,
Rastopchin E, Souchkevitch G, Tsyb A (2001) Ed. by Souchkevitch GN,
Repacholi MN: Low Doses of Ionizing Radiation: Health Effects and
77
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Assessment of Radiation Risks for Emergency Workers of the Chernobyl
Accident. Geneva: World Health Organization, 242 p.
Bomko MО (2004a): Morphometric neurovisual characteristic of organic brain damage
in remote period of exposure to ionizing radiation as a result of the Chernobyl
accident. Ukrainian Medical Journal, 2 (40): 96–101 [in Ukrainian].
Bomko MA (2004b) Morphometric neurovisual characteristic of organic brain damage in
clean-up workers of the consequences of the Chernobyl accident in remote
period of exposure to ionizing radiation. International Journal of
Psychophysiology, 54 (1–2): 119.
Bomko MO (2005) Structural-functional characteristic of organic mental disorders in
clean-up workers of the consequences of the Chernobyl accident in remote
period of exposure to ionizing radiation. The dissertation for the academic
degree of a Candidate of Medical Sciences in radiobiology. Research Centre for
Radiation Medicine of Academy of Medical Sciences of Ukraine. Kiev.
Bromet EJ, Gluzman S, Schwartz JE, Goldgaber D. (2002) Somatic symptoms in women
11 years after the Chornobyl accident. Environ Health Perspect, 110 (Suppl. 4),
625-629
Bromet EJ, Goldgaber D, Carlson G, Panina N, Golovakha E, Gluzman SF, Gilbert T,
Gluzman D, Lyubsky S, Schwartz JE. (2000) Children's well-being 11 years
after the Chornobyl catastrophe. Arch Gen Psychiatry, 57(6): 563-571
Buzunov VA, Strapko NP, Pirogova YeA, Krasnikova LI, Kartushin GI, Voychulene
YuS, Domashevskaya TYe (2001) Epidemiology of non-cancer diseas es among
Chernobyl accident recovery operation workers. International Journal of
Radiation Medicine, 3 (3–4): 9–25.
Buzunov VA, supervisor (2003) Pattern and Risks for Non-Cancer Chronic Diseases in
Chernobyl Accident Survivors on the Base of Cohort Studies, Development of
Models for Assessment and Forecasting taking into account Radiation and NonRadiation Factors. Final Report, Research Project 0100U003181, Kiev:
Scientific Centre for Radiation Medicine of Academy of Medical Sciences [in
Ukrainian].
Chuprikov AP, Pasechnik LI, Kryzhanovskaja LA, Kazakova SYe (1992) Mental
disorders at radiation brain damage. Kiev Research Institute for General and
Forensic Psychiatry [in Russian]
Danilov VM, Pozdeev VK (1994) The epileptiform reactions of the human brain to
prolonged exposure to low-dose ionizing radiation. Fiziol Zh Im I M Sechenova,
80 (6): 88–98 [Article in Russian].
Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP,
Angermeyer MC, Bernert S, de Girolamo G, Morosini P, Polidori G, Kikkawa
T, Kawakami N, Ono Y, Takeshima T, Uda H, Karam EG, Fayyad JA, Karam
AN, Mneimneh ZN, Medina-Mora ME, Borges G, Lara C, de Graaf R, Ormel J,
Gureje O, Shen Y, Huang Y, Zhang M, Alonso J, Haro JM, Vilagut G, Bromet
EJ, Gluzman S, Webb C, Kessler RC, Merikangas KR, Anthony JC, Von Korff
MR, Wang PS, Brugha TS, Aguilar-Gaxiola S, Lee S, Heeringa S, Pennell BE,
Zaslavsky AM, Ustun TB, Chatterji S; WHO World Mental Health Survey
Consortium (2004) Prevalence, severity, and unmet need for treatment of mental
disorders in the World Health Organization World Mental Health Surveys.
JAMA 291 (21): 2581–2590.
Ermolina LA, Sukhotina NK, Sosyukalo OD, Kashnikova AA, Tatarova IN (1996) The
effects of low radiation doses on children’s mental health (radiation-ontogenetic
aspect). Report 2. Social and Clinical Psychiatry, 6 (3): 5–13 [in Russian].
78
ECRR 2006: CHERNOBYL 20 YEARS AFTER
European Commission. Radiation protection 100 (1998) Guidance for protection of
unborn children and infants irradiated due to parental medical exposures.
Directorate-General Environment, Nuclear Safety, and Civil Protection
[http://www.europa.eu.int/comm/environment/radprot]
Fry RJ (2001) Deterministic effects. Health Phys 80 (4): 338–343.
Gamache GL, Levinson DM, Reeves DL, Bidyuk PI, Brantley KK (2005) Longitudinal
neurocognitive assessments of Ukrainians exposed to ionizing radiation after the
Chernobyl nuclear accident Arch Clin Neuropsychol, 20 (1): 81–93.
Gayduk FM, Igumnov SA, Shalckevich VB (1994) The complex estimation of neuropsychic development of children undergone to radiation exposure in prenatal
period as a result of Chernobyl disaster. Social and Clinical Psychiatry, 4 (1):
44–49 [in Russian]
Gelowitz DL, Rakic P, Goldman-Rakic PS, Selemon LD (2002) Craniofacial
dysmorphogenesis in fetally irradiated nonhuman primates: implications for the
neurodevelopmental hypothesis of schizophrenia. Biological Psychiatry 52 (7):
716–720.
Gourmelon P, Marquette C, Agay D, Mathieu J, Clarencon D. (2005) Involvement of the
central nervous system in radiation-induced multi-organ dysfunction and/or
failure. BJR Suppl. 27:62-68.
Gus’kova AK, Bisogolov GD (1971) Radiation Sickness of Human. Moscow:
«Meditzina» Publishing House [in Russian].
Gus’kova AK, Shakirova IN (1989): Reaction of the nervous system on alterative
ionizing irradiation. Zh Nevrol Psikhiatr Im S S Korsakova 89(2):138–142 [in
Russian].
Gutin PH, Leibel SA, Sheline GE (Eds.) (1991): Radiation injury to the nervous system.
New York: Raven Press.
Hall P, Adami HO, Trichopoulos D, Pedersen NL, Lagiou P, Ekbom A, Ingvar M,
Lundell M, Granath F (2004) Effect of low doses of ionising radiation in infancy
on cognitive function in adulthood: Swedish population based cohort study.
BMJ, 328(7430): 19–24.
Havenaar JM, Cwikel JG, Bromet EJ. (eds.) Toxic Turmoil: Psychological and Societal
Consequences of Ecological Disasters. New York, Kluwer Academic and
Plenum Press, 2002
Havenaar JM, de Wilde EJ, van den Bout J, Drottz-Sjöberg B-M, van den Brink W.
(2003). Perception of risk and subjective health among victims of the Chernobyl
disaster. Soc Sci Med, 56:569-572
Havenaar JM, Rumyantseva GM, van den Brink W, Poelijoe NW, van den Bout J, van
Engeland H, Koeter MWJ. (1997b) Long-term mental health effects of the
Chernobyl disaster: an epidemiological survey in two former Soviet Regions.
Am J Psychiatry 154:1605-1607
Havenaar JM, Rumyantzeva GM, Kasyanenko AP, Kaasjager K, Westermann AM, van
den Brink W, van den Bout J, Savelkoul TJF. (1997a). Health effects of the
Chernobyl disaster: illness or illness behaviour? A comparative general health
survey in two former Soviet Regions. Environ Health Perspect, 105 (Suppl.6):
1533-1537
Honda S, Shibata Y, Mine M, Imamura Y, Tagawa M, Nakane Y, Tomonaga M (2002)
Mental health conditions among atomic bomb survivors in Nagasaki. Psychiatry
and Clinical Neurosciences, 56: 575–583.
Hunt WA (1987) Effects of ionizing radiation on behavior. In: Conklin JJ, Walker RI,
editors. Military radiobiology. San Diego: Academic Press Inc. p. 321–330.
79
ECRR 2006: CHERNOBYL 20 YEARS AFTER
ICRP Publication 49 (1986) Developmental effects of irradiation on the brain of the
embryo and fetus. A report of a Task Group of Committee 1 of the International
Commission on Radiological Protection, 1986. In M.C. Thorne (Ed.). Annals of
the ICRP, 16 (4). Oxford: Pergamon Press.
ICRP Publication 60 (1991) 1990 Recommendations of the International Commission on
Radiological Protection. Annals of the ICRP, Vol. 21/1–3, Pergamon—Elsevier.
Igumnov S, Drozdovitch V. (2000). The intellectual development, mental and behavioral
disorders in children from Belarus exposed in utero following the Chernobyl
accident. Eur Psychiatry,15:244-253
Igumnov SA (1996) Psychological development of children exposed to radiation in
prenatal period as a result of Chernobyl disaster. The Acta Medica
Nagasakiensia. 41 (3-4): 20–25.
Igumnov SA (1999) The prospective investigation of a psychological development of
children exposed to ionizing radiation in utero as a result of the Chernobyl
accident. The dissertation for the academic degree of a Doctor of Medical
Sciences in radiobiology and psychiatry. State Scientific Center of Russian
Federation Institute of Biophysics, Moscow.
Igumnov SA, Drozdovitch VV (2004) Antenatal exposure following the Chernobyl
accident: neuropsychiatric aspects. International Journal of Radiation Medicine,
6 (1–4): 108–115.
Imamura Y, Nakane Y, Ohta Y, Kondo H (1999) Lifetime prevalence of schizophrenia
among individuals prenatally exposed to atomic bomb radiation in Nagasaki
City. Acta Psychiatrica Scandinavia, 100 (5), 344–349.
Ivanov VK, Maksioutov MA, Chekin Syu, Kruglova ZG, Petrov AV, Tsyb AF (2000)
Radiation-epidemiological analysis of incidence of non-cancer diseases among
the Chernobyl liquidators. Health Physics 78 (5): 495–501.
Ivanov VK, Maksiutov MA, Chekin SIu, Petrov AV, Tsyb AF, Biriukov AP, Kruglova
ZG, Matiash VA (2005) The radiation risks of cerebrovascular diseases among
the liquidators. Radiats Biol Radioecol, 45 (3): 261–270 [in Russian]
Jablensky A (2000) Epidemiology of schizophrenia: the global burden of disease and
disability. Eur Arch Psychiatry Clin Neurosci 250 (6): 274–285.
Kesminiene AZ, Kurtinaitis J, Rimdeika G (1997) The study of Chernobyl clean-up
workers from Lithuania. Acta Med. Lituanica 2: 55–61.
Kharchenko VP, Zubovskii GA, Kholodova NB (1995) Changes in the brain of persons
who participated in the cleaning-up of the Chernobyl AES accident based on the
data of radiodiagnosis (single-photon emission-computed radionuclide
tomography, x-ray computed tomography and magnetic resonance tomography)
Vestn Rentgenol Radiol, 1: 11–14 [in Russian].
Kholodova NB, Kuznetzova GD, Zubovsky GA, Kazakova PB, Buklina SB (1996)
Remote consequences of radiation exposure upon the nervous system. Zh
Nevropatol Psikhiatr Im S S Korsakova, 96 (5): 29–33.
Khomskaja ED (1995) Some results of neuropsychological study of Chernobyl accident
consequences clean-up workers. Social and Clinical Psychiatry, 5 (4): 6–10 [in
Russian].
Kimeldorf DJ, Hunt EL (1965) Ionizing radiation: neural function and behavior. New
York, Academic Press.
Kolominsky Y, Igumnov S, Drozdovitch V (1999) The psychological development of
children from Belarus exposed in the prenatal period to radiation from the
Chernobyl Atomic Power Plant. J Child Psychol Psychiatry, 40 (2): 299–305.
80
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Korr H, Thorsten Rohde H, Benders J, Dafotakis M, Grolms N, Schmitz C (2001)
Neuron loss during early adulthood following prenatal low-dose X-irradiation in
the mouse brain. Int. J. Radiat. Biol. 77 (5): 567–580.
Kovalenko AN, Loganovsky KN (2001): Whether Chronic Fatigue Syndrome and
Metabolic Syndrome X in Chernobyl accident survivors are membrane
pathology? Ukrainian Medical Journal, 6(26): 70–81 [in Russian].
Kozlova IA, Niagu AI, Korolev VD. (1999) The influence of radiation of the child
mental development. Zh Nevrol Psikhiatr Im S S Korsakova 99(8):12–15
[Article in Russian].
Krasnov VN, Yurkin MM, Vojtsekh VF, Skavysh VA, Gorobets LN, Zubovsky GA,
Smirnov YuN, Kholodova NB, Puchinskaja LM, Dudayeva KI (1993) Mental
disorders in clean-up workers of the Chernobyl accident consequences. Report I:
structure and current pathogenesis. Social and Clinical Psychiatry, 3 (1): 5–10
[in Russian]
Kusunoki Y, Kyoizumi S, Yamaoka M, Kasagi F, Kodama K, Seyama T (1999)
Decreased proportion of CD4 T cells in the blood of atomic bomb survivors
with myocardial infarction. Radiat Res 152 (5): 539–543.
Lebedinsky AV, Nakhilnitzkaja ZN (1960) Ionizing radiation influence on the nervous
system. Moscow, Publishing House Atomizdat [in Russian].
Litcher L, Bromet EJ, Carlson G, Squires N, Goldgaber D, Panina N, Golovakha E,
Gluzman S. (2000). School and neuropsychological performance of evacuated
children in Kiev eleven years after the Chernobyl disaster. J Child Psychol
Psychiatry, 41, 219-299
Loganovskaja TK (2004) Psychophysiological pattern of acute prenatal exposure to
lonizing radiation as a result of the Chernobyl accident. International Journal of
Psychophysiology, 54 (1–2): 95–96.
Loganovskaja TK (2005) Mental disorders in children exposed to prenatal irradiation as
a result of the Chernobyl accident. The dissertation for the academic degree of a
Candidate of Medical Sciences in radiobiology. Scientific Centre for Radiation
Medicine of Academy of Medical Sciences of Ukraine. Kiev.
Loganovskaja TK, Loganovsky KN (1999) EEG, cognitive and psychopathological
abnormalities in children irradiated in utero. Int J Psychophysiol 34 (3): 213–
224.
Loganovskaja TK, Nechayev SYu (2004): Psychophysiological effects in prenatally
exposed children and adolescents as a result of the Chernobyl accident. World of
Medicine, 4 (1): 130–137 [Article in Ukrainian]
Loganovsky K, Bomko M, Antypchuk Ye (2005b) Neuropsychiatric radiation effects:
lessons from Chernobyl accident. Accepted Abstract XIII World Congress of
Psychiatry Cairo, September 10-15, 2005 Egypt.
Loganovsky KN (1999) Clinical-Epidemiological aspects of psychiatric consequences of
the Chernobyl disaster. Social and Clinical Psychiatry, 1(9):5–17 [in Russian].
Loganovsky KN (2000a) Neurological and psychopathological syndromes in the followup period after exposure to ionizing radiation. Zh Nevrol Psikhiatr Im S S
Korsakova. 100(4):15-21 [in Russian]
Loganovsky KN (2000b) Vegetative-vascular dystonia and osteoalgetic syndrome or
Chronic Fatigue Syndrome as a characteristic after-effect of radioecological
disaster: the Chernobyl accident experience. Journal of Chronic Fatigue
Syndrome, 7(3): 3–16.
Loganovsky KN (2002) Mental disorders at exposure to ionising radiation as a result of
the Chernobyl accident: neurophysiological mechanisms, unified clinical
81
ECRR 2006: CHERNOBYL 20 YEARS AFTER
diagnostics, treatment. The dissertation for the academic degree of a Doctor of
Medical Sciences in radiobiology (03.00.01) and psychiatry (14.01.16).
Scientific Centre for Radiation Medicine of Academy of Medical Sciences of
Ukraine. Kiev.
Loganovsky KN (2003) Psychophysiological features of somatosensory disorders in
victims of the Chernobyl accident. Fiziol Cheloveka 29(1): 122–130
Loganovsky KN, Bomko MA, Antipchuk YeYu, Denisyuk NV, Zdorenko LL, Rossokha
AP, Chorny AI, Drozdova NV, Yukhimenko YeN, Kravchenko VI, Vasilenko
ZL (2004b) Postradiation brain damage in remote period of the Chernobyl
accident. International Journal of Psychophysiology54 (1–2): 149.
Loganovsky KN, Bomko MO (2004) Structural-functional pattern of radiation brain
damage in Chernobyl accident clean-up workers. Ukrainian Medical Journal, 5
(43): 67–74 [in Ukrainian].
Loganovsky KN, Kovalenko AN, Yuryev KL, Bomko MA, Antipchuk YeYu, Denisyuk
NV, Zdorenko LL Rossokha AP, Chorny AB, Dubrovina GV (2003)
Verification of organic brain damage in remote period of Acute Radiation
Sickness. Ukrainian Medical Journal, 6(38): 70–78 [in Ukrainian].
Loganovsky KN, Loganovskaja TK. (2000) Schizophrenia spectrum disorders in persons
exposed to ionizing radiation as a result of the Chernobyl accident. Schizophr
Bull 26:751-773
Loganovsky KN, Nyagu AI, Loganovskaja TK (1999) Chronic fatigue syndrome — a
possible effect of low and very low doses of ionizing radiation. In: Abstracts of
the International Conference «The effects of low and very low doses of ionizing
radiation on human health», June 16–18, 1999, Versal, France. Versal:
University of Versailles/St.Quentin-en-Yvelines, World Councol of Nuclear
Workers (WONUC), p 14.
Loganovsky KN, Volovik SV, Flor-Henry P, Manton KG, Bazyka DA (2004a) Ionizing
radiation as a risk factor for schizophrenia spectrum disorders. International
Journal of Psychophysiology, 54 (1–2): 106.
Loganovsky KN, Volovik SV, Manton KG, Bazyka DA, Flor-Henry P (2005a) Whether
ionizing radiation is a risk factor for schizophrenia spectrum disorders? World
Journal of Biological Psychiatry, 6(4): (accepted)
Loganovsky KN, Yuryev KL (2001) EEG patterns in persons exposed to ionizing
radiation as a result of the Chernobyl accident: part 1: conventional EEG
analysis. J Neuropsychiatry Clin Neurosci 13 (4): 441–458.
Loganovsky KN, Yuryev KL (2004) EEG patterns in persons exposed to ionizing
radiation as a result of the Chernobyl accident. Part 2: quantitative EEG analysis
in patients who had acute radiation sickness. J Neuropsychiatry Clin Neurosci
16 (1): 70–82.
Loganovsky KN, Zdorenko LL (2004) Intelligence deterioration following acute
radiation sickness. International Journal of Psychophysiology, 54 (1–2): 95.
Lysyanyj MI (1998) Current view on radiation effects on the nervous system. Bulletin of
Ukrainian Association of Neurosurgeons, 7: 113–118 [in Ukraine].
McGale P, Darby SC. (2005) Low doses of ionizing radiation and circulatory diseases: a
systematic review of the published epidemiological evidence. Radiat Res.
163(3): 247-57.
McGrath J., Saha S., Welham J., El Saadi Ossama, MacCauley C., Chant D. (2040) A
systematic review of the incidence of schizophrenia: the distribution of rates and
the influence of sex, urbanicity, migrant status and methodology. BMC
Medicine, 2:13 http://www.biomedcentral.com/1741-7015/2/13
82
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Mettler FA, Upton AC (Eds.) (1995) Medical effects of ionizing radiation. 2nd ed.
Saunders W. B. Company, Philadelphia.
Mickley GA (1987) Psychological effects of nuclear warfare, in: Conklin JJ, Walker RI,
editors. Military radiobiology. San Diego: Academic Press, Inc., pp 303–319.
Morozov AM, Kryzhanovskaja LA (1998) Clinic, dynamic and treatment of borderline
mental disorders in liquidators of Chernobyl accident. Kiev, Publishing House
Chernobylinterinform [in Russian].
Nakane Y, Ohta Y (1986) An example from the Japanese Register: some long-term
consequences of the A-bomb for its survivors in Nagasaki. In: Ten Horn
GHMM, Giel R, Gulbinat WH, Henderson JH (eds) Psychiatric Case Registers
in Public Health. Elsevier Science Publishers B.V., Amsterdam, pp 26–27.
Napreyenko A, Loganovsky K (2001a) Psychiatric management of radioecological
disaster victims and local wars veterans. New Trends in Experimental and
Clinical Psychiatry, XVII (1–4): P. 43–48.
Napreyenko AK, Loganovskaja TK (2004) Mental disorders in prenatally irradiated
children and adolescents as a result of the Chernobyl accident: diagnostic
system, treatment and rehabilitation. World of Medicine, 4 (1): 120–129 [Article
in Ukrainian].
Napreyenko AK, Loganovsky KN (1995) The systematics of mental disorders related to
the sequelae of the accident at the Chernobyl Atomic Electric Power Station Lik
Sprava, 5-6:25–29 [in Russian].
Napreyenko AK, Loganovsky KN (1997) Ecological psychiatry, Kiev Polygraphkniga
Publishing House [in Russian].
Napreyenko AK, Loganovsky KN (1999) Current problems of emergency psychiatry at
the radioecological disaster. In: Emergency psychiatry in a changing world Ed.
by M. De Clercq, A. Andreoli, S. Lamarre, P. Forster. Amsterdam: Elsevier
Science B.V., pp 199–202.
Napreyenko AK, Loganovsky KN (2001b) Ecological psychiatry. In: Psychiatry, edited
by Napreyenko AK, Kiev: Zdorovja, Publishing House, pp 417–461 [in
Ukrainian].
Niagu AI, Noshchenko AG, Loganovskii KN (1992) Late effects of psychogenic and
radiation factors of the accident at the Chernobyl nuclear power plant on the
functional state of human brain Zh Nevropatol Psikhiatr Im S S Korsakova, 92
(4): 72–77 [in Russian].
Nijenhuis MAJ, van Oostrom IEA, Sharshakova TM, Pauka HT, Havenaar JM, Bootsma
PA. (1995). Belarussian-Dutch Humanitarian Aid Project: "Gomel Project.”
Bilthoven, National Institute for Public Health and Environmental Protection
Noshchenko AG, Loganovskii KN (1994) The functional brain characteristics of people
working within the 30-kilometer area of the Chernobyl Atomic Electric Power
Station from the viewpoint of age-related changes. Lik Sprava, 2: 16–19 [in
Russian].
Nyagu A, Khalyavka I, Loganovsky K, Plachinda Yu, Yuriev K, Loganovskaja T.
(1996c) Psychoneurological characterization of persons who had acute radiation
sickness. Problems of Chernobyl Excluzion Zone, 3: 175–190 [in Russian].
Nyagu A, Loganovsky K, Loganovskaja T, Antipchuk Ye (1996a) The WHO Project on
«Brain Damage in Utero»: mental health and psychophysiological status of the
Ukrainian prenatally irradiated children as a result of the Chernobyl accident. In:
Bambino: Progetto Salute. Proc. of Int. Meeting on prenatal, perinatal and
neonatal neurological damages: preventive and therapeutic approach, Ancona,
Italy, June 12-13, 1996, pp 34–58.
83
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Nyagu AI, Cheban AK, Salamatov VA, Limanskaja GF, Yazchenko AG. Zvonaryeva
GN, Yakimenko GD, Melina KV, Plachinda YuI, Chumak AA, Bazyka DA,
Gulko GM, Chumak VV, Volodina IA (1993) Psychosomatic health of children
irradiated in utero as a result of the Chernobyl accident. In: (Ed.) Nyagu AI.
Proceedings of the International Conference «Social, Psychological, and
Pscyhoneurological Aspects of Chernobyl NPP Accident Consequences», Kiev,
September 28-30, 1992. Kiev: Association «Physicians of Chernobyl»,
Ukrainian Scientific Centre for Radiation Medicine, pp. 265–270 [in Russian]
Nyagu AI, Loganovsky KN (1998) Neuropsychiatric effects of ionizing radiation. Kiev,
Publishing House Chernobylinterinform [in Russian].
Nyagu AI, Loganovsky KN, Cheban AK, Podkorytov VS, Plachinda YuI, Yuriev KL,
Antipchuk YeYu, Loganovskaja TK (1996b) Mental health of prenatally
irradiated children: a psychophysiologycal study. Social and Clinical Psychiatry
6 (1): 23–36 [Article in Russian].
Nyagu AI, Loganovsky KN, Chuprovskaya NYu, Kostychenko VG, Vaschenko EA,
Yuryev KL, Zazymko RN, Loganovskaya TK, Myschznchuk NS (2003):
Nervous system. In: Vozianov A, Bebeshko V, Bazyka D, editors. Health
Effects of Chornobyl Accident. Kiev: DIA, pp 143–176.
Nyagu AI, Loganovsky KN, Loganovskaja TK, Repin VS, Nechaev SYu (2002a)
Intelligence and brain damage in children acutely irradiated in utero as a result
of the Chernobyl accident. In: Imanaka T, editor. KURRI-KR-79. Recent
Research Activities about the Chernobyl NPP Accident in Belarus, Ukraine and
Russia. Kyoto: Research Reactor Institute, Kyoto University, pp 202–230.
Nyagu AI, Loganovsky KN, Loganovskaja TK. (1998). Psychophysiologic aftereffects of
prenatal irradiation. Int J Psychophysiol, 30, 303-311
Nyagu AI, Loganovsky KN, Nechayev SYu, Repin VS, Antipchuk YeYu, Loganovskaya
TK, Bomko MA, Yuryev KL, Petrova IV, Pott-Born R (2004a) Potential effects
of prenatal brain irradiation as a result of the Chernobyl accident in Ukraine. In:
Abstracts of International Workshop on «The French-German Initiative Results
and their Implication for Man and Environment», Kiev, October 5–6, 2004, p.
38.
Nyagu AI, Loganovsky KN, Pott-Born R, Nechayev SYu, Repin VS, Antipchuk YeYu,
Loganovskaya TK, Bomko MA, Yuryev KL, Petrova IV (2004b) FrancoGerman Initiative for Chernobyl, Project N°3 «Health Effects on the Chernobyl
Accident», Sub-Project No 3.4.1: «Potential Effects of Prenatal Irradiation on
the Brain as a Result of the Chernobyl Accident (Ukraine)», Final Report.
Nyagu AI, Loganovsky KN, Pott-Born R, Repin VS, Nechayev SYu, Antipchuk YeYu,
Bomko MA, Yuryev KL, Petrova IV (2004c) Effects of prenatal brain
irradiation as a result of the Chernobyl accident. International Journal of
Radiation Medicine, 6 (1–4): 91–107.
Nyagu AI, Loganovsky KN, Yuryev KL (2002b) Psychological consequences of nuclear
and radiological accidents: delayed neuropsychiatric effects of the acute
radiation sickness following Chernobyl. In: Follow-up of delayed health
consequences of acute accidental radiation exposure. Lessons to be learned
from their medical management. IAEA-TECDOC-1300, IAEA, WHO. Vienna:
IAEA, P. 27–47
Nyagu AI, Loganovsky KN, Yuryev KL, Zdorenko LL (1999) Psychophysiological
aftermath of irradiation. International Journal of Radiation Medicine 2 (2): 3–
24.
84
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Otake M, Schull WJ (1984) In utero exposure to A-bomb radiation and mental
retardation: A reassessment. British Journal of Radiology 57: 409–414.
Otake M, Schull WJ (1998) Radiation-related brain damage and growth retardation
among the prenatally exposed atomic bomb survivors. International Journal of
Radiation Biology, 74 (2), 159−171.
Otake M, Schull WJ, Lee S (1996) Threshold for radiation-related severe mental
retardation in prenatally exposed A-bomb survivors: a re-analysis. International
Journal of Radiation Biology, 70 (6), 755−763.
Preston DL, Shimizu Y, Pierce DA, Suyama A, Mabuchi K (2003) Studies of mortality
of atomic bomb survivors. Report 13: Solid cancer and noncancer disease
mortality: 1950–1997. Radiat Res 160(4):381–407.
Rahu M, Tekkel M, Veidebaum T, Pukkala T, Hakulinen A, Auvinen A, Rytomaa T,
Inskip PD, Boice JD Jr. (1997). The Estonian study of Chernobyl clean-up
workers: II. Incidence of cancer and mortality. Radiation Res, 147, 653-657
Rajendran R, Raju GK, Nair SM, Balasubramanian G (1992) Prevalence of oral
submucous fibrosis in the high natural radiation belt of Kerala, south India. Bull
World Health Organ. 1992;70(6):783-9.
Revenok AA (1998) Psychopathic-like disorders in persons with an organic brain lesion
as a result of exposure to ionizing radiation Lik Sprava. 3: 21–24 [in Russian].
Revenok OA (1999) Structural and dynamical characterization of organic brain damage
in persons exposed to ionizing radiation as a result of the Chernobyl accident
The dissertation for the academic degree of a Doctor of Medical Sciences in
psychiatry. Ukrainian Research Institute for General and Forensic Psychiatry,
Kiev.
Romanenko AY, Nyagu AI, Loganovsky KN, Tirmarche M., Gagniere B., Buzunov VA,
Ledoschuk BA, Trocyuk N, Yuryev KL, Zdorenko LL, Antipchuk YeYu,
Bomko MA, Loganovskaya TK, Petrova IV, Kartushin GN, Khmelko VYe,
Paniotto VI, Zakhozha VA (2004a) Franco-German Initiative for Chernobyl
Project N°3 «Health Effects on the Chernobyl Accident» Sub-Project No 3.4.8:
«Data Base on Psychological Disorders in the Ukrainian Liquidators of the
Chernobyl Accident», Final Report.
Romanenko AY, Nyagu AI, Loganovsky KN, Tirmarche M., Gagniere B., Buzunov VA,
Ledoschuk BA, Trocyuk N, Kartushin GN, Khmelko VYe, Paniotto VI,
Zakhozha VA, Yuryev KL, Zdorenko LL, Antipchuk YeYu, Bomko MA,
Loganovskaya TK, Petrova IV (2004b) Data base on psychological disorders in
the Ukrainian liquidators of the Chernobyl accident. In: Abstracts of
International Workshop on «The French-German Initiative: Results and Their
Implication for Man and Environment», October 5-6, 2004, Kiev, pp 56–57.
Romodanov AP, Vynnyts’kyj OR (1993) Brain lesions in mild radiation sickness. Lik
Sprava, 1: 10–16 [in Ukrainian].
Ron E, Modan B, Flora S, Harkedar I, Gurewitz R (1982) Mental function following
scalp irradiation during childhood. Am. J. Epidemiol. 116: 149–160.
Rumyantseva GM, Chinkina OV, Levina TM, Margolina VYa (1998) Mental
disadaptation of the Chernobyl accident clean-up workers. Russian Medical
Journal. Contemporary Psychiatry, 1 (1): 56–63 (http://www.rmj.ru
/sovpsih/t1/n1/8.htm; http://www.rmj.ru/p1998_01/8.htm)
Sasaki H, Wong FL, Yamada M, Kodama K (2002) The effects of aging and radiation
exposure on blood pressure levels of atomic bomb survivors. J Clin Epidemiol
55(10):974–981.
85
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Schindler MK, Wang L, Selemon LD, Goldman-Rakic PS, Rakic P, Csernansky JG
(2002) Abnormalities of thalamic volume and shape detected in fetally
irradiated rhesus monkeys with high dimensional brain mapping. Biological
Psychiatry 51 (10): 827–837.
Schull W, Otake M Yoshimaru H (1988) Effect on intelligence test score of prenatal
exposure to ionising radiation in Hiroshima and Nagasaki: A comparison of the
T65DR and DS86 dosimetry systems. Technical Report RERF 3–88. Hiroshima:
Radiation Effects Research Foundation.
Schull WJ (1997) Brain damage among individuals exposed prenatally to ionizing
radiation: a 1993 review. Stem Cells, 15 Suppl 2: 129–133.
Schull WJ, Otake M (1999) Cognitive function and prenatal exposure to ionizing
radiation. Teratology, 59 (4), 222–226.
Shabadash AL (1964) Cytochemical characterization of reactivity and inhibit-protective
states of the nervous cells at radiation injuries. In: Restoration processes at
radiation injuries. Moscow: Atomizdat Publishing House, pp. 53–60 [in
Russian].
Shimizu Y, Pierce DA, Preston DL, Mabuchi K (1999) Studies of the mortality of atomic
bomb survivors. Report 12, part II. Noncancer mortality: 1950–1990. Radiat Res
152(4):374–389.
Torubarov FS, Blagoveshchenskaia VV, Chesalin PV, Nikolaev MK (1989) Status of the
nervous system in victims of the accident at the Chernobyl atomic power plant.
Zh Nevrol Psikhiatr Im S S Korsakova 89 (2): 138–142 [in Russian].
Trocherie S, Court L, Gourmelon P, Mestries J-C, Fatome M, Pasquier C, Jammet H,
Gongora H, Doloy MTh (1984) The value of EEG signal processing in the
assessment of the dose of gamma or neutron-gamma radiation absorbed dose.
In: Court L, Trocherie S, Doucet J (eds) Le Traitment du Signal en
Electrophysiologie Experimentale et Clinique du Systeme Nerveux Central, Vol.
II, pp. 633–644.
Tsirkin SIu (1987) International study of schizophrenia based on a WHO program.
Comparative characteristics of the data. Zh Nevropatol Psikhiatr Im S S
Korsakova 87 (8): 1198–1203 [in Russian]
Turuspekova ST (2002) Neuropsychological functions in individuals exposed to small
dose ionizing radiation. Zh Nevrol Psikhiatr Im S S Korsakova 102 (3): 16–19
[in Russian].
UNSCEAR 1982 Report to the General Assembly, with Scientific Annexes. United
Nations Scientific Committee on the Effects of Atomic Radiation. United
Nations, New York, Vol. 2, Biological Effects.
UNSCEAR 1993 Report to the General Assembly (1993): Annex I. Late deterministic
effects in children. Sources and effects of ionizing radiation. UNSCEAR 1993
Report to the General Assembly, with Scientific Annexes. United Nations
Scientific Committee on the Effects of Atomic Radiation. United Nations, New
York, pp. 899–908.
UNSCEAR 2000 report to the General Assembly (2000), Annex J. Exposures and effects
of the Chernobyl accident. International Journal of Radiation Medicine, Special
issue, 2–4 (6–8): 3–109.
UNSCEAR 2000 report to the General Assembly, with scientific annexes. Sources and
effects of ionizing radiation. United Nations Scientific Committee on the Effects
of Atomic Radiation. New York: United Nations, Vol. I: Sources.
86
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Vasculescu T, Pasculescu G, Papilian V, Serban I, Rusu M (1973) The effect of low Xray doses on the central nervous system. Radiobiol. Radiother. (Berl.), 14 (4):
407–416.
Viinamäki H, Kumpusalo E, Myllykangas M, Salomaa S, Kumpusalo L, Kolmakov S,
Ilchenko I, Zhukowsky G, Nissinen A. (1995). The Chernobyl accident and
mental wellbeing - a population study. Acta Psychiatr Scand, 91: 396-401
Voloshina NP (1997) Structural and functional brain disorders in patients with dementia
of different genesis. The dissertation for the academic degree of a Doctor of
Medical Sciences in neurology and psychiatry. Kharkiv Institute of Advanced
Medical Studies, Kharkiv, Ukriane.
Volovik S, Loganovsky K, Bazyka D (2005) Chronic Fatigue Syndrome: molecular
neuropsychiatric projections. Abstract XIII World Congress of Psychiatry Cairo,
September 10-15, 2005 Egypt, p. 225.
Vyatleva OA, Katargina TA, Puchinskaya LM, Yurkin MM (1997)
Electrophysiological characterization of the functional state of the brain in
mental disturbances in workers involved in the clean-up following the
Chernobyl atomic energy station accident. Neurosci Behav Physiol, 27 (2): 166–
172.
World Health Organization (1996) Health consequences of the Chernobyl accident.
Results of the IPHECA pilot projects and related national programmes. Geneva,
World Health Organization
World Health Organization (2001) World Health Report 2001. Mental health: New
understanding, new hope. Geneva: World Health Organization.
World Health Organization (2005) Health Effects of the Chernobyl Accident and Special
Health Care Programmes. Report of the UN Chernobyl Forum Expert Group
«Health» (EGH), Working Draft, August 31, 2005, 179 p.
http://www.iaea.org/NewsCenter/Focus/Chernobyl/index.shtml
Yaar I, Ron E, Modan B, Rinott Y, Yaar M, Modan M (1982) Long-lasting cerebral
functional changes following moderate dose X-radiation treatment to the scalp
in childhood: an electroencephalographic power spectral study. J. Neurol.
Neurosurg. Psychiatry 45 (2): 166–169.
Yaar I, Ron E, Modan M, Perets H, Modan B (1980) Long–term cerebral effects of small
doses of X–irradiation in childhood as manifested in adult visual evoked
responses. Ann. Neurol. 8: 261–268.
Yamada M, Izumi S (2002) Psychiatric sequelae in atomic bomb survivors in Hiroshima
and Nagasaki two decades after the explosions. Soc. Psychiatry Psychiatr.
Epidemiol. 37: 409–415
Yamada M, Kasagi F, Sasaki H, Masunari N, Mimori Y, Suzuki G (2003) Association
between dementia and midlife risk factors: the radiation effects research
foundation adult health study. J Am Geriatr Soc 51(3):410–414.
Yamada M, Kodama K, Wong FL. (1991). The long-term psychological sequelae of
atomic bomb survivors in Hiroshima and Nagasaki. In Ricks R., Berger M.E.,
O’Hara R.M. (Eds), The medical basis for radiation preparedness III: The
psychological perspective. New York: Elsevier, pp. 155-163
Yamada M, Sasaki H, Mimori Y, Kasagi F, Sudoh S, Ikeda J, Hosoda Y, Nakamura S,
Kodama K (1999) Prevalence and risks of dementia in the Japanese population:
RERF’s adult health study Hiroshima subjects. Radiation Effects Research
Foundation. J Am Geriatr Soc 47(2):189–195.
Yamada M, Wong FL, Fujiwara S, Akahoshi M, Suzuki G (2004) Noncancer disease
incidence in atomic bomb survivors, 1958–1998. Radiat. Res., 161: 622–632.
87
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Zdorenko LL, Loganovsky KN (2002) Mental working capacity in liquidators with
organic mental disorders in the remote period after the Chernobyl accident.
Ukrainian Medical Journal, 4 (30): 120–126 [in Ukrainian].
Zhavoronkova LA, Gabova AV, Kuznetsova GD, Sel'skii AG, Pasechnik VI, Kholodova
NB, Ianovich AV (2003) Post-radiation effect on the interhemispheric
asymmetry in EEG and thermography characteristics. Zh Vyssh Nerv Deiat Im I
P Pavlova 53 (4): 410–419 [in Russian].
Zhavoronkova LA, Gogitidze NV, Kholodova NB (1996) The characteristics of the late
reaction of the human brain to radiation exposure: the EEG and
neuropsychological study (the sequelae of the accident at the Chernobyl Atomic
Electric Power Station) Zh Vyssh Nerv Deiat Im I P Pavlova 46 (4): 699–711 [in
Russian]
Zhavoronkova LA, Gogitidze NV, Kholodova NB (2000) Postradiation changes in the
brain asymmetry and higher mental functions of right- and left-handed subjects
(the sequelae of the accident at the Chernobyl Atomic Electric Power Station)
Zh Vyssh Nerv Deiat Im I P Pavlova 50 (1): 68–79 [in Russian].
Zhavoronkova LA, Kholodova NB, Gogitidze NV, Koptelov IuM (1998) A dynamic
assessment of the reaction of the human brain to radiation exposure (the
aftermath of the accident at the Chernobyl Atomic Electric Power Station). Zh
Vyssh Nerv Deiat Im I P Pavlova 48 (4): 731–742 [Article in Russian].
Zhavoronkova LA, Kholodova NB, Zubovskii GA, Smirnov IuN, Koptelov IuM, Ryzhov
NI (1994) The electroencephalographic correlates of neurological disorders in
the late periods of exposure to ionizing radiation (the aftereffects of the accident
at the Chernobyl Atomic Electric Power Station) Zh Vyssh Nerv Deiat Im I P
Pavlova 44 (2): 229–238 [in Russian].
Zhavoronkova LA, Kholodova NB, Zubovskii GA, Smirnov YuN, Koptelov YuM,
Ryzhov NI (1995a): Electroencephalographic correlates of neurological
disturbances at remote periods of the effect of ionizing radiation (sequelae of the
Chernobyl' NPP accident). Neurosci Behav Physiol 25 (2): 142–149.
Zhavoronkova LA, Kholodova NB, Zubovsky GA, Gogitidze NV, Koptelov YM (1995b)
EEG power mapping, dipole source and coherence analysis in Chernobyl
patients. Brain Topogr, 8 (2): 161–168.
Zozulya YuP (ed.) (1998) Chronic influence of small doses of ionizing radiation:
experimental studies and clinical observations. Kiev, Publishing House
Chernobylinterinform [in Ukrainian].
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CHAPTER 4
The Influence of the Chernobyl Accident on Wild Vertebrate Animals.
Dr. Eugene Yu. Krysanov, PhD MD,
Institute of Ecology and Evolution
Russian Academy of Sciences
Moscow
Russia
In this chapter I review briefly the biological effects in natural populations of vertebrate
animals exposed to the radiation from the Chernobyl accident.
For radiological effects, the most important stage was the initial period after the
accident. In this period radioactive nuclides accumulated in different systematic and
ecological groups of animals and, accordingly, these systems suffered the highest dose load
and radiation effects. The ecological consequences have not stabilized. On radioactively
polluted land several processes are occurring.
From the point of revealing the consequences of radio-ecological exposures, there
are a number of biocenoses which were initially contaminated. First of all there is the
region of the “Red Forest” and the cooling tank of Chernobyl NPS. On the territory of this
“Red Forest” there was a sharp decrease in the population of murine rodents. This resulted
from the effects of high dose loads; later on, these populations were gradually recreated
(Taskaev et al., 1988).
In small mammals, studies showed increased embryonic death and an increase in
the level of variable cells of the dominant lethal mutations, of reciprocal translocations,
deviations of the morphological content of blood and embryonic pathologies (Zainullin,
1998; Pomerantzeva, Ramaja, 1999; Sokolov et al., 1999).
In the cooling pond of Chernobyl NPS the death of separate hydrocoles was not
found. There was, however, a short-term depression of benthic organisms. In fish – the
most sensitive hydrocoles – there were changes on organ indices, on tissue and on
cytogenic levels. It was reported that, in 31 species of fish, the maximum influence of 137Cs
occurred in predator species of the lithophilous group (spawning on stony soil). These
include zander and asp. In 1998 the dose rate received by fish, by embryos and by larvae
from the bottom sediments was about 10-20 cGy/day, from the water – 2-3 mGy/day.
During 1989-1990, the survival of silver carp was studied from the moment of spawning
and the dose of radiation of both individuals was 7 - 8 Gy. Biochemical analysis showed
that the energy sources, the reproductive capacity and general indices did not differ from
the norm, but 8 % of males were sterile. The young fish of silver carp received 15 cGy. The
Cytogenetic analysis revealed 22,7% of deviations in the irradiated fish (5-7 % in the
control group), but it was noted that in the pond there was not only the radiation factor, but
chemical and thermal influences also (Ryabov 2004).
In other territories, where the radiation levels were not so acute, there was no mass
death of animals, no cases of expressed organ radiation disease and no radio-specific
anomalies in the breeding or in the behavior of animals. In discussing the high radioresistance of natural eco-systems in general and in its specific elements in animals, it is of
interest to mention the numerous radiation effects that occur in lower levels of biological
organization. In this connection the ecological indexes, which are used for the
characteristics of populations and of animal communities, seem to show the influence of
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only large doses of radiation. The influence of small doses of radiation seems to be
apparent only at the molecular and cellular levels. The numerous data on the radiation
effects in different species of animals that have been reported at levels lower than the ecosystem level of biological organization and on territories situated far enough from the most
radioactive areas are the proof of this.
Among such effects on wild animals that inhabit radiation polluted biocenoses we
may include the cytogenic deviations in amphibians and in small mammals. There have
been reports of differences in many levels of biochemical parameters between mammals in
the polluted zone and those in clean territories. Destructive changes in liver and in
Hemopoietic organs, an increase in the response of the immune system, changes in energy,
carbohydrate and in albumin kinetics and in their regulation, genetic effects and the
increase of fluctuating asymmetry have all been reported by many researchers observing
murine rodents and also in some other species of wild animals in the 30-km zone relative to
regions with lower levels of pollution. (Biological ..., 1990; Zakharov & Krysanov, 1996).
In addition, it was reported that there were defects in the process of growth and in
the development of sex cells and their structure in fish (oocyte and nucleus measurement
aberrations, aberrations in oocyte development, asyncronous oocyte growth, thickening of
follicular membrane, nucleus disintegration, etc.). The authors concluded that there was a
negative influence in the effects of continuous radiation exposure of both the environment
and the tissues and organs in fish gametogenesis. (Petukhov & Kokhnenko, 1998)
Low radiation doses (absorbed dosage rate from internal and external irradiation of
order of 0.4–5.5 m Gy/day) were shown to induce negative biological effects in pond carp
reared in radiocontaminated ponds (specific activity of bottom sediments — 801–
3235 Bq/kg). In particular, it was reported that there were reductions in reproductive
parameters in stripped fishes, a rise in the frequency of morphological changes and
cytogenetic injuries in embryos and larvae. A rise in the frequency of morphological
changes and cytogenetic injuries in carp aged 1-summer was also noted (Slukvin &
Goncharova, 1999).
Cytomorphological analysis of pike gonads was conducted in another study. This
revealed some deviations from the normal development of oocytes. A major part of oocytes
at the period of vitellogenesis in fish from lakes Perstok and Smerzhov resulted from germ
cells with degenerative changes. The thickness of the radial membrane in pike egg cells
reached 25- 30 mcm; its normal thickness being about 10 mcm. Deviations in female gonad
development and in gonads of pike were also observed. It was concluded that a negative
influence of reservoir radiocontamination on reproductive process could, in future, result in
a reduction in the reproductive ability of the above-studied species populations (Kokhenko,
2000).
One study compared the results obtained from Apodemus agrarius, Microtus
oeconomus and Microtus arvalis caught in the spring of 1987, which inhabited territories
with low ((0,02 - 0,1 mR/h), medium (2 - 20 mR/h) and high (150 - 200 mR/h) levels of
gamma-radiation. Results revealed several kinds of hepatocyte dystrophy, deviations in the
energy systems efficiency in the organ. Decrease in the activity of SDG, PDG and LDG
were the most essential changes, but there was no significant connection with the level of
external radiation (Shishkina et al., 1992).
Another study reported a statistically significant increase in the level of
cytogenetic injuries (aberrant cells) in bone marrow and the intestinal epithelium of
amphibians and rodents, in the alveolar macrophages of rodents, as well as an increase in
the micronuclei level in erythrocytes of amphibian peripheral blood. (Yeliseeva et al.,
1996).
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Goncharova et al. (1996) reported a high frequency of chromosome aberrations
and a rise in the level of genome mutations up to 1991 (decreasing with the dose absorbed).
They noted an indication of increased sensitivity of hereditary structures in the somatic
cells of new animal generations, descendants of the generations of 1986-1988 and, hence,
argued that this showed an absence of genetic adaptation to the mutagenic effect of radiocontamination in natural populations during the whole period of their investigations.
The detected cytogenetic effects of chronic low-intensive irradiation in the germ
and somatic cells of wild animals exceeded the expected levels deduced from extrapolation
of the data from the high-dose range of acute or chronic irradiation. In wild murine rodents
increased frequencies of cytogenetic injuries in somatic and germ cells, as well as
embryonal lethality, were shown to remain over the life spans of no less than 22
generations (Goncharova & Ryabokon, 1998).
Another study shows that there appears to be a malfunction of erythropoiesis
function at low radiation exposure. After 20 generations of field voles from contaminated
areas, an excess level of mutation process is taking place in somatic cells, despite an
essential decrease of radiation exposure (Smolich & Ryabokon, 1997).
As usual, registered changes are not linearly connected with the power of the
absorbed dose. This underlines the difficulty of predicting radiation effects, especially at
the low dose level.
Similarly, there seems to be no direct dependence between the level of the
accumulation of the radioactive nuclides and the biological effects (the frequencies of the
variable cells, micronuclei, and fluctuating asymmetry).
The increasing radio-resistance, with the passage of time, of populations existing
in polluted biogeocenoses has, however, been reported at low levels of pollution. (Il’enko
& Krapivko, 1994).
Most of the research had been carried out on small mammals with a lesser number
of studies devoted to this problem focusing on other groups of animals (fish and
amphibians).
In general, the majority of studies are devoted to the problems of accumulation
and transformation of radioactive nuclides by animals (Ryabov, 2004; Lebedeva &
Ryabtzev, 1999; Bondarkov et al., 2002, 2002a; Kuchmel et al, 2003; Oleksik et al., 2002;).
It is worth noting that most studies were carried out within the first decade after
the accident rather than the second.
Thus, the long term biological effects in natural populations of animals, long after
the initial damage, are less likely to have been studied well. Some of these studies show
long-term effects.
One interesting study examined genetic diversity in bank voles from Chernobylcontaminated sites and uncontaminated sites. The workers sampled three geographic sites;
Oranoe, a reference site with virtually no radioactive contamination (<2 Ci/km2) and two
highly contaminated sites; Glyboke Lake and the “Red Forest” (both 1,000 Ci/km2).
Genetic diversity in the population from the “Red Forest” (0.722 ± 0.024) was significantly
greater than at the Oranoe reference site (0.615 ± 0.039), while genetic diversity at Glyboke
Lake (0.677 ± 0.068) was intermediate (Matson et al., 2000).
The level of erythroblasts with micronuclei in peripheral blood in Rana temporaria
larvae caught in the stream in the Central Botanical Gardens area (National Academy of
Sciences of Belarus, Minsk) was 6 times higher than the control — the population from
Berezinsky reserve (p<0.001). A significant excess (3- 4 times) of the micronuclei number
as against the control (p<0.001) was observed in brown frog larvae caught near v. Veprin in
the Chericov district of the Mogilev region. The number of erythrocytes with micronuclei
in all the populations of brown frogs from radiocontaminated areas caught before 1991 was
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shown to be higher than in the control and, in some cases, by a factor of 30 (p<0.001).
During long-term monitoring of the populations of both brown and narrow-muzzled frogs
inhabiting radio-contaminated areas it was discovered that, besides an increased yield of
cytogenetic damage in bone marrow cells and erythrocytes, different levels of change took
place in the ratio of erythrocyte number in peripheral blood. Deviations in erythron towards
an increase in the specific weight of small and large cells were noted in 1988 - 1989 in
animals of all the populations inhabiting radiocontaminated areas (Voitovich, 2000).
According to our own data, the frequency of aberrant cells in some species of
small mammals remains rather high even today. Among bank vole they are about 6-8% in
the most polluted areas of the Bryansk Region. These values are higher then the control
values by 3-4 times. In addition, in the populations of red field-voles we studied, a high
frequency of individuals had maximum values of aberrant cells (2005 data).
High values of aberrant cells in some species of hydrocoles from the tanks of 10
km zone of Chernobyl accident were also noted. The frequency of aberrant cells in perch
from the cooling pond of Chernobyl NPP is about 6%, which is 2-times higher than the
background values. In Crucian carp, from Glubokoe Lake, the frequency of variable cells is
about 10 % (Gudkov et al., 2004).
The frequency of aberrant cells in the lake frog from lake Glubokoe is about 6-7%
(author data 2005), which is lower then noted in 1988, but 2-3 times higher then the
spontaneous (Krysanov, 1993).
At the same time, it was found that there was a decrease in the level of reciprocal
translocations and of micronucleus in natural populations of small mammals 15-18 years
after the damage. (Pomerantzeva et al., in press, Rodgers & Baker. 2000).
From this short review we may conclude that, with regard to populations of wild
animals inhabiting radioactively contaminated territories, the situation has altered from its
pre-contamination one and continues to change today.
It seems that significant but subtle damage caused the Chernobyl NPP radiation is
a factor which has caused different and sometimes unobvious changes in these populations,
which, as a consequence, may lead to the transformation of the karyotype of the gene pool
and to other transformations also.
References
Biological and radioecological aspects consequences accident on Chernobyl NPP. 1990.
Moscow. 230p.
Bondarkov M.D., Gashak S.P., Goryanaya Ju. A., Maksimenko A.M., Ryabushkin A.N.,
Salyi O.V., Shulga A.A., Awan S., Chesser B.E., Rodgers B.E.,Some
characteristics of 90Sr and 137Cs metabolism in newborn bank voles Int. Cher.
Center, Kiev, 2002, 477-485.
Bondarkov M.D., Gashak S.P., Goryanaya Ju. A., Maksimenko A.M., Shulga A.A.,
Chigevsky I.V., Oleksik T.K.,Features of radioactive contamination of amphibians
of Chernobyl region. 2002. Int. Cher. Center, Kiev, 508-517
Goncharova R.I., Ryabokon N.I. The results of long-term monitoring of animal populations
chronically irradiated in radiocontaminated areas. Radiological catastrophe in
Chernobyl: report of international study. Tokyo, 1998. P. 256–266. (Jap)
Goncharova R.I., Ryabokon N.I., Slukvin A.M.. Dynamics of mutability in somatic and
germ cells of animals inhabiting regions of radioactive fall-out. Cytology and
Genetics. 1996. V. 30, № 4. P. 35-41. (Rus)
Gudkov D.I., Derevets V.V., Kuzmenko M.I., Nazarov A.B., Krot Yu.G., Kipnis L.S.,
Mardarevich M.G., Syvak O.V.Hydrobionts of the Chernobyl NPP exclusion
92
ECRR 2006: CHERNOBYL 20 YEARS AFTER
zone: present-day level of radioactive contamination dose rates and cytogenetic
effects. 2004., Proc. II Int. Conf., Tomsk, 167-171. (Rus).
Il’enko A.I., Krapivko T.P., Radioresistance of bank voles populations (Clethrionomys
glareolus) in conditions of radioactive contamination. Proc. Natl. Acad. Sci. Rus.,
1994. v. 336, N5, 714-718. (Rus)
Krysanov E. Yu. 1993. Chromosome aberrations in lake frogs from Chernobyl zone in
1987. In: Impact of Radiation from Chernobyl accident. Proc. First All Union
Conf., “Gidrometeoisdat”, St-Pet., v. 2, 27-29 (In Russian)
Kuchmel S.V., Deryabina T.G., Ostudin I.A., Antonuk G.A., Specific activity of 137Cs in
organs and tissues of wild hoofed of Polessye reservation. 6th Ann. Conf. Int.
Cern. Center, 2003, 216 (Rus).
Lebedeva N. V., Ryabtzev I.A. Accumulation of radionuclides in birds. 1999. Bioindication
of radioactive pollutions Moscow. Nauka, 72-85 (Rus)
Matson C.W., Rodgers B. E., Chesser R.K.,Baker R.J. Genetic diversity of Clethrionomys
glareolus populations from highly contaminated sites in the Chornobyl region,
Ukraine. 2000, Envir. Toxicol. Chem., 19, 2130-2135
Oleksik T. R., Gashak S.P., Glenn T.S., Jagoe C.H., Peles J. D., Purdue J. R., Tsyusko
O.V., Zalissky O.O., Smith M.H., Frequency distributions of 137Cs in fish and
mammal populations. J. Envir. Rad., 2002, v. 61, 55-74.
Petukhov V.B., Kokhnenko O.S. Gametogenesis of bream and roach under radioactive
contamination of cisterns of Belarus. Proc. Natl. Acad Sci. Bel., Ser. Biology.
1998. N 3. P. 115-120. (In Russian)
Pomerantzeva M D., Ramaya L.K., 1999. Genetical effects of high level of radiation in
mice on contaminated area of Chernobyl (in Bioindication of radioactive
contamination (Ed. D. Krivolutzky), 187-199. (In Russian)
Pomerantzeva M D., Ramaya L.K., Rubanovich A.N. 2006. Genetical consequences of the
increased radiating background at rodents. Radiobiology and Radioecology (in
press).
Rodgers B. E. and R. J. Baker. 2000. Frequencies of micronuclei in bank voles from zones
of high radiation at Chernobyl, Ukraine. Environmental Toxicology and
Chemistry. 19:1644-1649.
Ryabov I.I., Radioecology of fishes of reservoirs in region influences of accident on the
Chernobyl atomic power station, 2004, Moscow, КМК, 215 с. (In Russian)
Shishkina L. N., Matteriy L.D., Kudyasheva A.G., Zagorskaya N.G., Taskaev A.I.
Structurally functional infringements in a liver of wild mammals from areas of
accident}on the Chernobyl atomic power station. Radiobiology. 1992. v. 32, N 1,
19-29. (Rus)
Slukvin A.M., Goncharova R.I. Radiation-induced biological effects in pond carp and
measures of their prevention. Proc. of Intern. Conf. On Present State and Prospects
of Aquaculture Development, Gorki, 7 – 9 December 1999. Gorki, 1999. P.136–
138. (Rus)
Smolich I.I., Ryabokon N.I. Micronucleus frequency in somatic cells of red vole
(clethorionomus glareolus) from the populations of chronic radiation exposure.
Proc. Natl. Acad Sci. Bel., Ser. Biology. 1997. № 4. P. 42-46. (Rus)
Sokolov V.E., Krylova T.E., Skurat L.N., 1999. Embryonic development of rodent in
chronic irradiatin impact on forest biogeocenoses (in Bioindication of radioactive
contamination (Ed. D. Krivolutzky), 123-128 (In Russian)
Sushchenya L.M., Pikulik M.M., Plenin A.E. (eds), 1995. Animals in the zone of the
Chernobyl atomic power electric station. Minsk "Navuka i tekhnika", 263 p. (In
Russian)
93
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Taskaev A.I., Testov B.V., Matteriy L. D., 1988, Ecological and morphoecological
consequences accident on the Chernobyl NPP for populations of small mammals,
Syktyvkar, 56. (In Russian)
Testov V.V., Taskaev A.I., Ryabov I.N., Ryabtsev LA. 1993. Changes in abundance of
rodents on the site with various pollution levels. In: Impact of Radiation from
Chernobyl accident. Proceedings of the First All Union Conference. (Obninsk,
June 1988), vol. 2, Ed. Yu.A. Israel, St-Pet.., "Gidrometeoisdat", 147-150. (In
Russian)
Voitovich A.M. Micronuclei frequency in erythrocytes and disturbance in differentiation
process in brown-frog erythron under chronic radiation exposure // Proc. Natl.
Acad. Sci., 2000. N.3. P.60- 63. (rus).
Yeliseeva K.G., Kartel N.A., Voitovich A.M., Trusova V.D., Ogurtsova S.E., Krupnova
E.V. Chromosome aberrations in various tissues of murine rodents and
amhpibians. Cytology and Genetics. 1996. V. 30, № 4. P. 20-24. (Rus)
Zainullin Genetical effect of chronic irradiatin in low doses of ionizing radiation, 1998. St.
Petersburg, Nauka, 99p. (In Russian)
Zakharov V.M. & Krysanov E.Yu., Eds., 1996 Consequences of the Chernobyl
Catastrophe: Environmental Health, Moscow, 160. (In Russian)
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CHAPTER 5
Chromosome Aberrations in the Blood Lymphocytes of People
Exposed to Radiation as a Result of the Chernobyl Accident.
1
G.P.Snigiryova1, V.A.Shevchenko2
Federal State Institution Russian Scientific Center of Roentgenology & Radiology
Roszdrav, Moscow, Russia
2
Vavilov Institute of General Genetics, Moscow, Russia
In the process of examining people exposed to radiation, a large volume of information has
been accumulated during the twenty years since the accident at the Chernobyl nuclear
power plant. The negative effects of the accident adversely affected the health of many
people. Among them are the liquidators– the largest and most seriously affected category of
irradiated population of our country and the residents of settlements within the zones of
radioactive fallout.
The most important role of these examinations is the prediction of genetic effects
of ionizing radiation on the human organism and the assessment of the risk of future
development of pathologies. These tasks can be successfully accomplished only with
reliable information on accumulated irradiation doses. Unfortunately, in an emergency
situation such as took place at the Chernobyl NPP in 1986, it is very difficult to assess the
real radiation load with only the help of the limited physical dosimetry data available at that
time. The biological methods, namely, the cytogenetic ones, based on the analysis of the
frequency of chromosome aberrations make a considerable contribution to solving these
problems. These methods allow a quantitative estimation of the effect of radiation on the
human organism taking into account its individual peculiarities (first of all, individual
radio-sensitivity) and the condition of the organism at the time of irradiation. The data
obtained with these methods provide a more accurate prediction of possible early and
remote consequences of irradiation.
The principles of the cytogenetic method of dosimetry were convincingly
substantiated in numerous works in Russia and abroad and the results of those works served
as the basis for the recommendations worked out by WHO, IAEA and UNSCEAR on the
practical use of chromosomal analysis of blood lymphocytes in determining the doses of
exposure.
The radiobiological basis for employing cytogenetic methods in radiation
investigations is a high sensitivity of blood lymphocytes and the availability of radiationspecific chromosome rearrangements, the dependence of which on dose has been studied
for most types of ionizing radiation.
The action of radiation leads to the occurrence of chromosome aberrations of the
exchange type - dicentrics, polycentrics, centric rings, translocations and acentric
fragments. Of primary interest in studying these radiation effects, especially in the course of
quantitative analysis, is the frequency of dicentrics and translocations. The analysis of
dicentrics is successfully applied in biodosimetric estimations of the doses of irradiation
shortly (within a year) after a single, relatively uniform, radiation exposure. The advantage
of the analysis of dicentrics is their easy detection with a light microscope without the
complicated procedures of treatment and staining of chromosome preparations. The limited
application of this method is due to the fact that cells with such aberrations, being
genetically unbalanced, may be eliminated in the course of the cell cycle. As the post-
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
radiation period increases, the uncertainty in dose estimations on the basis of the frequency
of dicentrics also significantly increases. In this case the residual frequency of dicentrics in
peripheral blood lymphocytes permits the presence or absence of radiation damage to be
established.
A more promising method in biological dosimetry is the analysis of translocations.
Using this method it is possible to determine the degree of radiation injury in the organism
and to estimate the irradiation dose within a long period after the exposure. This is possible
due to the fact that, in contrast to dicentrics, translocations do not disturb the process of
mitosis and therefore can easily be transmitted through a series of cell generations, i.e., the
frequency of translocations does not significantly change with the time after irradiation
The spontaneous frequency of dicentrics and translocations is characterized by
relatively low values and averages between 0 and 5 per 10,000 cells for dicentrics. The
spontaneous frequency of translocations is approximately one order of magnitude higher.
Using the frequency of chromosome aberrations it is possible to estimate relatively low
doses. The lower limit of sensitivity is 0.01 Gy for dicentrics and about 0.25 Gy for
translocations [1].
Despite the restrictions of the analysis of dicentrics used for retrospective
estimation of irradiation doses, it has found wide use in cytogenetic monitoring in groups of
people exposed to irradiation in an emergency. An increased level of chromosome
aberrations in blood lymphocytes may precede the development of pathological processes
in the human organism and therefore information on the extent of genome damage is
extremely important in the formation of groups at risk of developing various diseases,
including oncological ones [2,3].
Cytogenetic examinations acquired special importance in connection with the
accident at the Chernobyl NPP, due to which large contingents of people were exposed to
irradiation of varying intensity. Much attention in literature was initially given to the
cytogenetic examination of the liquidators of the accident and populations from regions
with radioactive contamination. During the examination of 158 workers of the nuclear
power plant and liquidators at the clinic of the Institute of Biophysics, irradiation doses in
the range from 0.1 to 13.7 Gy were estimated by means of cytogenetic analysis [4]. The
accuracy of these estimates was confirmed by the later clinical state of the patients.
In the course of cytogenetic monitoring of the liquidators Maznik et al. [5]
established that the average dose calculated by the data of cytogenetic analysis was higher
than the values officially recorded in the documents.
Pilinskaya et al. [6] noted that during examination of the liquidators with a known
irradiation dose, the positive correlation between the cytogenetic results and the data of
physical dosimetry was not always observed. The dose values calculated on the basis of
cytogenetic analysis were, as a rule, lower, which, in the opinion of the authors, is due to
the elimination of unstable chromosome aberrations with the post-irradiation time.
However, one cannot but note that there are numerous works [7,8,9,10,11] in
which evidence for an increased level of unstable chromosome aberrations (dicentrics,
centric rings and acentric fragments) in blood lymphocytes of the liquidators is presented.
According to the authors, the observed changes are retained over many years after the
radiation exposure. Sevan’kaev et al. [8] carried out a cytogenetic examination of 875
liquidators (1-6 years after the accident) who worked in Chernobyl for two weeks to three
months. An increased frequency of the indicators of radiation damage – dicentrics and
centric rings – was observed only in groups of liquidators who worked between 1986-1988.
In those who worked in 1989 the frequency of chromosome aberrations did not differ from
the control values. Estimation of individual doses was not possible because of too low
values of the cytogenetic indices. Nevertheless, the average doses calculated for the
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
examined groups by the frequency of dicentrics were in agreement with the data of personal
dosimeters. Bogomazova [9] carried out a cytogenetic examination of the population
irradiated as a result of the accident at the Chernobyl NPP (liquidators and people
evacuated from regions contaminated with radionuclides). 4-10 years after the accident the
frequency of unstable chromosome aberrations in the blood of the examined people
exceeded the control level.
Much attention in the literature was given to the cytogenetic examination of
children living on radioactive territories.
In the course of 17 years, Sevan’kaev et al. [10] carried out cytogenetic
examinations of children and teenagers from contaminated territories of the Kaluga region.
Throughout the whole period of examination an increased level of unstable chromosome
aberrations was observed in 30-60% of the examined subjects. The authors did not discover
an increase in the frequency of chromosome aberrations with an increase in the dose load.
While examining children living in radionuclide-contaminated areas of the
Zhitomir and Kiev regions, Pilinskaya et al. [11] established that the highest level of
chromosome aberrations was in children living within a territory with a maximum level of
exposure.
It should be noted that some ambiguity in the data presented in the works of
various researchers is due to an insufficient number of examined cells (sometimes no more
than 100 cells), which, in some cases, may lead to incorrect conclusions.
In the early 1990s there appeared works in which the FISH method was used for
analyzing stable chromosome aberrations in people who suffered from the Chernobyl
accident.
The results of examination of the liquidators with large doses of irradiation are
presented in the work of Sevan’kaev et al. [12]. Retrospective estimation of irradiation
doses by the frequency of dicentrics and translocations was made 5 years after the accident.
The dose values obtained by the two methods were in agreement.
Data for an increase in the frequency of stable translocations in blood lymphocytes
of people exposed at different times to irradiation of different character are presented in the
work [13].
On the basis of the data obtained in the course of analysis of the frequency of
stable translocations in blood lymphocytes of the liquidators, determination of irradiation
doses was made 5-10 years after the Chernobyl accident [14]. The average dose for the
examined group of liquidators was 9 cGy (from 0 to 51 cGy). These values were lower
compared to the data of physical dosimetry. Little correlation (<0.2) was noted between the
biological and physical doses.
This work presents the results of cytogenetic examination of people exposed to
irradiation as a result of the accident at the Chernobyl NPP. The possibility of using
cytogenetic data for assessing the doses of irradiation and predicting the negative impacts
of radiation exposure is also considered.
Results and Discussion
Cytogenetic examination of the liquidators. Biodosimetry.
During their activities in Chernobyl the liquidators were exposed to short-term,
prolonged or fractional irradiation with different dose rates. Partial and rather incomplete
information on irradiation doses determined with the physical methods of dosimetry does
not permit an objective assessment of the radiation damage. Taking into consideration that
the level of chromosome rearrangements in blood lymphocytes correlates with the value of
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
irradiation dose, a more accurate estimate of the consequences of the accident in terms of
both individual and population dosimetry can be obtained through cytogenetic analysis.
In 1986 443 liquidators were cytogenetically examined using the classical method (analysis
of dicentrics). Blood samples were collected a few days after the end of their work within
the 30 km zone. Table 1 shows the data of the cytogenetic analysis and biological
dosimetry for the examined group of liquidators. As follows from the presented data, the
frequency of dicentrics is 16.5 times higher than the control level. The irradiation doses
were estimated using a calibration dose-effect curve for dicentrics [15] constructed on the
basis of experimentally obtained data (acute gamma-irradiation of blood samples at a dose
rate of 0.103 Gy/min). The curve is described by a linear quadratic equation:
Y = (0.10 ± 0.03) + (1.5 ± 0.4)*D + (6.3 ± 0.3)*D2,
where Y is the frequency of dicentrics per 100 cells, D is the dose of irradiation, Gy.
Table 1. Frequency of chromosome aberrations (classical method) in a group of
dators examined in 1986.
Groups
Number
of patients
Number of
cells
*dic ± m/
100 cells
Liquidators
443
41927
0.33 ± 0.01*
Biological estimate
of dose, Gy (95%
C.I.)
0.16
(0.07 – 0.42)
Control
114
51430
0.02 ± 0.01
*significance of differences as compared to the control, р<0.05; dic = dicentrics
The average dose for the examined group of liquidators was 0.16 Gy. According to the data
[16], an average dose of irradiation for a representative group of liquidators from Russia
constituted 0.12 Gy. The average values of irradiation doses for the liquidators working in
Chernobyl in 1986 approached 0.16 Gy [17].
In the period from 1992 to 1995 a cytogenetic analysis with the use of the FISH
method was carried out for 52 liquidators who participated in the restoration works in
Chernobyl since 1986. The results of this analysis and biological dosimetry for the given
group are presented in Table 2.
Table 2. The results of cytogenetic examination (FISH method) and average
irradiation doses in the liquidators
Groups
Number
of patients
Number
of cells
Translocations
FG ± m/ 100 cells
All
52
44283
1.20 ± 0.16*
liquidators
Liquidators 35
27767
0.86 ± 0.13*
1986
Liquidators 17
15516
1.81 ± 0.35*
1986-1995
Control
15
21953
0.47 ± 0.09
* significance of differences as compared to the control, р<0.05
Biological
estimate of
dose, Gy (95%)
0.27(0.05-0.50)
0.19(0.05-0.50)
0.39(0.10-0.80)
-
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The frequency of translocations in the examined group exceeds 2.5-fold the control level.
17 examined liquidators worked in Chernobyl periodically from 1986 to 1995, i.e., they
were exposed to long-term fractional irradiation. The frequency of translocations in this
group is 4 times higher than in the control group and 2 times higher than in the group of
liquidators (35 patients) who worked in Chernobyl only in 1986. This may be due to the
fact that the liquidators who repeatedly took part in the clean-up works over several years
received a higher total dose compared to the liquidators who worked in Chernobyl only in
1986. The irradiation doses were calculated by the frequency of translocations using a
calibration dose-effect curve [18]. An average dose for the whole examined group of
liquidators (52 persons) constituted 0.27 Gy. For the group of liquidators who repeatedly
worked in Chernobyl in the period from 1986 to 1995 the dose of irradiation made up 0.39
Gy and for the liquidators who worked only in 1986 - 0.19 Gy.
It should be noted that the doses estimated by the frequency of translocations and
dicentrics for the liquidators of 1986 are in good agreement with and do not significantly
contradict the data obtained with the physical methods of dosimetry.
The doses determined for the liquidators by means of cytogenetic analysis are
equivalent to the doses of acute single irradiation as they were calculated with the help of
calibration curves plotted for acute irradiation with a rather high dose rate (0.5 Gy/min). In
reality, the liquidators were, as a rule, exposed to long-term fractional low-intensity
irradiation. Therefore, in some cases, the real irradiation doses might be much higher. This
largely concerns the liquidators who came to work in Chernobyl several times over a long
period. This important fact must be taken into account when analyzing the health condition
of the liquidators.
Cytogenetic monitoring of the liquidators.
Figure 1 presents the results of long-term analysis of the frequency of chromosome
aberrations (namely, dicentrics) in blood lymphocytes of the liquidators who took part in
the restoration works in Chernobyl in 1986. In the first year of examination the average
frequency of dicentrics in the group of liquidators was 0.33 per 100 cells and exceeded the
control level 16.5-fold. In succeeding years the value of this parameter gradually decreased
(approximately 2-fold) compared to the first year of examination. However, throughout the
whole period of examination, up to 2004, the frequency of dicentrics in blood lymphocytes
of the liquidators remained significantly higher compared to the control values – from 0.10
to 0.14 per 100 cells.
99
0,35
0,3
0,25
0,2
0,15
0,1
0,05
0
co
nt
ro
l
19
86
19
87
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
20
9
00 9
-2
20 00
02 1
-2
00
3
20
04
Frequency of dicentrics per 100 cells
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Years
Fig.1 Average frequency of dicentrics in a group of liquidators examined at
different times after the accident
The fact of an increase in the frequency of cytogenetic disturbances in the liquidators was
confirmed by numerous investigations and is now beyond question. However, the
interpretation of the results involves certain difficulties. There is an opinion that genome
destabilization is the basic pathogenetic mechanism for the development of various somatic
diseases. Despite the lack of direct evidence for the influence of increased chromosome
variability in somatic cells on the health of the liquidators, a considerable amount of recent
data demonstrates the contribution of somatic mutations to the development of a number of
diseases. At present, the results of investigations concerning somatic pathologies and
general morbidity among liquidators remain rather contradictory. Many researchers
revealed unfavorable tendencies in the dynamics of some classes of somatic diseases in the
liquidators: an increase in the incidence of diseases of the cardiovascular and osteoarticular
systems, nervous system, psychical sphere, as well as disturbances in metabolism and cases
of immunodeficiency. Examinations of the patients’ dynamics reveal progressive
deterioration in the state of their health [19]. Functional disturbances are transformed with
time into organic ones and a mild form of a disease into a grave one.
Cytogenetic monitoring of the liquidators in combination with the examination of
their health condition will permit reliable information to be gathered on the correlation
between the frequency of chromosome aberrations and the risk of development of somatic
diseases.. At present there are literature data [20, 21] on a significant correlation between
the frequency of chromosome aberrations and the risk of carcinogenesis. Therefore it seems
to be important during cytogenetic examination of the liquidators to differentiate groups
with different genetic risks depending on the level of chromosome aberrations in peripheral
blood lymphocytes. Patients with a high degree of genetic risk need constant medical
examination for the negative consequences of irradiation to be established and prevented.
100
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Cytogenetic examination of the Bryansk region residents.
Between 1992-1994 cytogenetic examinations were carried out among residents of the
Bryansk region living in areas contaminated with radionuclides after the accident at the
Chernobyl nuclear power plant. It should be emphasized that, due to differences in the
levels of contamination and in the radionuclide composition of the radioactive fallout and
also due to a wide range of biogeochemical characteristics in the territory, the cytogenetic
examination of the population for the purpose of assessing the injurious action of radiation
acquires particular importance. Under such circumstances the data obtained with only the
help of the physical methods of dosimetry cannot be used for unbiased assessment of the
negative impacts of irradiation.
Table 3 presents the results of examinations of the population in the Bryansk
region. Since no significant differences were revealed in the cytogenetic parameters
between the groups living in the zones of different social-economic status, all examined
people were united in one group. The results of cytogenetic analysis were compared with
the control data to draw a conclusion about the possible harmful action of radiation on the
human cell genome. In the group of examined residents of the Bryansk region the total
frequency of chromosome aberrations was 1.43 per 100 cells. This value is 2 times higher
than in the control group. Ionizing radiation induces mainly aberrations of the chromosomal
type, first of all dicentrics, in cells of living organisms. The frequency of dicentrics in the
examined group made up 0.1 per 100 cells and exceeded 5-fold that in the control group.
These data are in good agreement with the results of cytogenetic examination of children
and teenagers from the Kaluga region living on radionuclide-contaminated territories [10].
Table 3. The results of cytogenetic examination (classical method) of the
population of the Bryansk region
No. of
patients
No.
of
cells
Bryansk
region
80
21027
Control
114
51430
ab± m/
100 cells
1.43 ±
0.08*
0.66 ±
0.04
(dic+
Rc) ±
m/
100
cells
0.10 ±
0.02*
0.02 ±
0.01
ace ± m/
100 cells
chr ±
m/
100
cells
0.36 ±
0.04
0.23 ±
0.02
0.93 ±
0.07
0.41 ±
0.03
* significance of differences compared to the control, р<0.05
ab – total number of aberrations; dic – dicentrics; Rc - centric rings; ace – acentric
fragments; chr – aberrations of the chromatid type.
An increased level of dicentrics - indicators of radiation damage – in people from
contaminated territories suggests a constant mutagenic influence of the radiation factors on
the human organism.
It should also be noted that the level of chromatid aberrations in the examined
group is 2 times higher compared to the control value. Chromosome aberrations of this type
occur from the action of mutagens predominantly in S- and G2-phases of the cell cycle,
which is characteristic for an overwhelming majority of chemical agents and viruses [22].
The increased level of chromatid aberrations may be due to chemical environmental
pollution both as a result of the accident and as a result of intensive application of
pesticides and chemical fertilizers. One cannot rule out the influence on the cell’s genetic
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
apparatus of constant long-term low-intensity irradiation from radionuclides entering the
human organism from the environment with food products.
Conclusion
To sum up the results of long-term monitoring of cytogenetic effects in the Chernobyl
liquidators and in people from contaminated territories it is necessary to state the following;
• analysis of chromosome aberrations in blood lymphocytes is one of the
most important and necessary tasks when examining the victims of the
Chernobyl accident;
• the results of cytogenetic analysis (classical and FISH) can be successfully
used for indication and quantitative assessment of the effects of radiation
on the human organism. The doses calculated on the basis of cytogenetic
examination take into account such important factors as individual
radiosensitivity and the condition of health at the time of irradiation.
Hence the obtained information permits a more exact prediction of
unfavorable consequences of irradiation, including the estimation of
genetic risk;
• analysis of morbidity in the groups of irradiated people examined with
cytogenetic methods will help determine the correlation between the
frequency of chromosome aberrations in somatic cells and the risk of
development of pathological processes. This will be of use in working out
sensitive criteria for the early detection of negative changes in the health
condition of exposed people.
The authors are sincerely grateful to the scientific workers of the Cytogenetic Laboratory of
RSC RR N.N.Novitskaya, E.D.Khazins and A.N.Bogomazova for technical assistance in
preparing this publication.
1.
2.
3.
4.
5.
6.
7.
References
United Nations. Sources and Effects of Ionizing Radiation. UNSCEAR 2000
Report to the General Assembly with Scientific Annexes. United Nations
sales publication. No.E.00.IX.4. New York. 2000.
Snigiryova G.P., Lyubchenko P.N., Shevchenko V.A. et al. // Hematol. and
Transfusiol. 1994. V.39. N 3. P.19-21. (in Russ.)
Kholodova N.B., Zubovsky G.A., Snigiryova G.P. IIIrd scientific-practical
regional conference on “The Condition of Health of the Liquidators of the
Accident at the Chernobyl NPP at a Distant Period”. Moscow. 2004. P.176.
(in Russ.)
Retrospective dosimetry of liquidators of the Consequences of the Accident
at the Chernobyl Nuclear Power Plant. By ed.: Kruychkov V.P. and
Nosovskii A.V., Kiev, 1996, P.256. (in Russ.)
Maznik N.A., Vinnikov V.A., Toyplaya V.A. et al. Proceedings of
International Conference “Emergency Situations: Notification and
Liquidation of Consequences”, Kharkov, 2000, P.200-205. (in Russ.)
Pilinskaya M.A., Shemetun A.M., Bondar’ A.Yu., Dyibskii S.S. // Vestnik
AMS SSSR. 1991. N 8. P.40-45. (in Russ.)
Pilinskaya M.A., Shemetun A.M., Bondar’ A.Yu., Dyibskii S.S. // Cytol.
And Genetics. 1996. N 2. P.17-25. (in Russ.)
102
ECRR 2006: CHERNOBYL 20 YEARS AFTER
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
103
Sevan’kaev A.V. // Rdaiat. Biology. Radioekology. 2001. V.40. N5. P.589595 (in Russ.)
Bogomazova A.N. The study of stable and unstable chromosome aberrations
in people exposed as a results of the Chernobyl accident in late term after
irradiation. Master’s thesis. S.-Petersburg. 2000. (in Russ.)
Sevan’kaev A.V., Mikhailova G.F., Potetnya O.I. // Radiat. Biology.
Radioecology. 2005. V.45. N 1. P.5-15.
Pilinskaya M.A., Shemetun A.M., Dyibskii S.S. et al. // Cytol. and Genetics.
1994. N3. P.27-32. (in Russ.)
Sevan’kaev A.V., Lloyd D.C., Edwards A.A. and Moiseenko V.V. //
Radiation Protection Dosimetry. 1995. V.59. N2. P.85-91. (in Russ.)
Vorobtsova I.E., Mikhel’son V.M., Vorob’eva M.V. et al. // Radiat. Biology.
Radioecology. 1994. V.34. N6. P.798-803. (in Russ.)
Moor D.H., Tucker J.D., Jones I.M. et al. // Radiation Research. 1997.
V.148. P.463-475.
Snigiryova G.P., Bogomazova A.N., Novitskaya N.N. et al. // Proc. Intern.
Conference "Genetic Consequences of Emergency Radiation Situations".
Moscow: RUDN. 2002. P. 313 - 328.
Waison A.A., Zhakov I.G., Knizhnikov V.A. et al..// Med. Radiology. 1990.
N10.
P. 21-28. (in Russ.)
Liberman A.N. Radiation and reproductive health. S.- Petersburg: 2003. 225
p. (in Russ.)
Bauchinger M., Schmid E., Zitzelsberger H. et al. // Int. J. Radiat. Biol.
1993. V. 64.
P. 179-184.
Kharchenko V.P., Kholodova N.B., Snigiryova G.P. // Medical
Anthropology. Minsk: 2004. P.213-214. (in Russ.)
Bonassi S.,Znaor A., Norppa H., Hagmar L.. // Cytogenet. Genome
Res.2004. V. 104. P.376-382.
Rossner P., Boffetts P., Ceppi M. et al. // Environ. Health Perspectives. 2005.
V.113. N5. P.517-520.
Natarajan T., Boei J., Darroudi F. et al // Environ. Health Perspectives. 1996.
V.104.
N 3. P. 445-448.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
CHAPTER 6
Radiation- induced Effects in Humans After in utero Exposure: Conclusions
from Findings After the Chernobyl Accident
Short title: Teratogenic Effects after Chernobyl
Inge Schmitz-Feuerhake*
Department of Physics, University of Bremen, Germany Abstract. A threshold dose of 100 mSv is assumed for radiation-induced teratogenic effects
in publication No. 90 of the ICRP (2003), which is based on the findings in the Japanese Abomb survivors. A variety of observations about congenital malformations, foetal loss,
stillbirths, and infant deaths, as well as Down´s syndrome after the Chernobyl release make
manifestly clear the incompleteness and inadequacy of the Japanese data in these areas. The
radiation-induced developmental effects of Chernobyl, especially at great distances, are
usually denied because of the low values of the estimated human exposures. Biological
dosimetry in contaminated regions, however, shows that physical dose estimations lead to
considerable underestimations of the true exposure. The assumptions about teratogenic
effects by incorporated radionuclides have to be revised.
Introduction
The evaluation of radiaton risks by international radiation protection committees is based
on findings concerning Japanese A-bomb survivors. The effects observed there after
prenatal exposure were mental retardation and reduced head size, while no other significant
detriment was detected. The period between the 8th and 15th week of gestation is thought to
be the period of greatest risk.
As was pointed out by different, researchers the Japanese data suffer, however, from
several restrictions which limit their suitability as a general base for deriving radiation
risks. One point is a probable and proven severe selection bias because of the catastrophic
situation after the bombing. Another objection which must be stressed, especially
considering perinatal effects, is the fact that the investigations of the Radiation Effects
Research Foundation (RERF) in Hiroshima did not begin earlier than 5 years after the
catastrophe when the RERF research institute was established there. The completeness of
the data must therefore be put into question.
The reduced selection of assumed effects and the assertion of a threshold dose as high
as 100 mSv by the ICRP contradicts former findings in experimental research (Table 1) and
several observations in humans previous to the Chernobyl accident. Tables 2-5 list the
results of studies in regions affected by fallout from the latter.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 1. Minimum dose below 100 mSv which showed significant effects after in utero xray exposure in experimental studies (data taken from Fritz-Niggli, 1997)
Mice
Rats
Dose
mSv
10
50
50
50
Days after
conception
8
0.5
0.5; 1.5
7.5
10
50
18
0.4; 0.7
Effects
Reference
Cumulated
developmental defects
Death of the embryo
Death of the embryo,
polydactyly
Death of the embryo,
skeletal malformations
Reflex distortions
Foetal death
Michel, FritzNiggli 1977
Rugh, Grupp
1959
Ohzu 1965
Jacobsen 1966
UNSCEAR
1986
Roux et al. 1983
Table 2 Observed increase of congenital malformations in utero after exposure by the
Chernobyl accident
Country
Effects
References
Belarus
National
Genetic
Monitoring
Registry
Anencephaly, spina bifida, cleft
lip and/or palate, polydactyly,
limb reduction defects,
esophageal atresia, anorectal
atresia, multiple malformations
Lazjuk et al. 1997
Congenital malformations
Bogdanovich 1997;
Savchenko 1995
Belarus
Highly
exposed region
of Gomel
Chechersky
district of the
Gomel region
Kulakov et al. 1993
Congenital malformations
Petrova et al. 1997
Shidlovskii 1992
Mogilev
region
Congenital malformations
Brest region
Congenital malformations
Ukraine
Polessky
district of the
Kiev region
Congenital malformations
Kulakov et al. 1993
Godlevsky, Nasvit 1998
Lygyny region
Turkey
Anencephaly, spina bifida
Akar et al.1988/89;
Caglayan et al. 1990;
Güvenc et al. 1993;
Mocan et al. 1990
106
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Bulgaria,
region of
Pleven
Malformations of heart and
central nervous system, multiple
malformations
Moumdjiev et al. 1992
Croatia
Malformations by autopsy of
stillborns and cases of early
death
Kruslin et al. 1998
Cleft lip and/or palate
Zieglowski, Hemprich
1999
Germany
German
Democratic
Republic,
Central
registry
Bavaria
Annual Health
Report of West
Berlin 1987
City of Jena
(Registry of
congenital
malformations)
Cleft lip and/or palate
Congenital malformations
Scherb, Weigelt 2004
Korblein 2003a, 2004;
Scherb, Weigelt 2003
Strahlentelex 1989
Lotz et al. 1996
Malformations in stillborns
Isolated malformations
Table 3 Observed increase of stillbirths, infant deaths, spontaneous abortions and low birth
weight after in utero exposure by the Chernobyl accident
Country
Effects
References
Belarus
Selected regions
Perinatal deaths*)
Petrova et al. 1997
Chechersky District
near Gomel
Perinatal deaths
Kulakov et al. 1993
Gomel region
Perinatal deaths
Korblein 2003a,b
Perinatal deaths, reduced
birth rate**), premature
births
Kulakov et al. 1993
Ukraine
Polessky District near
Kiev
Lygny region
Early neonatal deaths
Zhitomir oblast, Kiev
region, Kiev City
Perinatal deaths, reduced
birth rate
Europe: Greece,
Hungary, Poland,
Stillbirths
107
Godlevsky, Nasvit 1998
Korblein 2003a,b
Scherb et al. 1999b,
2000b, 2003
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Sweden
Infant mortality
Korblein 2003a
Poland
Spontaneous abortions
Ulstein et al. 1990
Norway
Low birth weight
Czeisel 1988
Hungary
Premature births among
malformed children
Reduced birth rate
Stillbirths
Harjulehto et al. 1989
Germany
Total (FRG + GDR)
Perinatal deaths
Southern Germany
Early neonatal deaths
Korblein, Kuchenhoff
1997; Scherb et al.
2000a,2003
Bavaria
Perinatal deaths,
stillbirths
Finland
Reduced birth rate
Harjulehto et al. 1991
Scherb, Weigelt 2003
Lüning et al. 1989
Grosche et al. 1997;
Scherb et al. 1999a,
2000a, 2003
Korblein 2003a
*) Perinatal deaths summarize stillbirths and deaths in the first 7 days from birth
**) Reduced birth rate is considered as a measure for spontaneous abortions
Table 4 Increase of Down´s syndrome after in utero exposure by the Chernobyl accident
Region
Results
References
Belarus
National Genetic
Monitoring Registry
Excess 1987-1994 ca. 17
%
Lazjuk et al. 1997
Western Europe
Beginning 1 yr after the
accident, reaching 22%
within 3 years
Dolk et al. 1999
Sweden
“Slight“ excess in most
exposed areas (30 %)
Ericson, Kallen 1994
Scotland, Lothian
region (0.74 million
inhabitants)
Excess peak in 1987 (2fold significant)
Ramsay et al. 1991
South Germany
Investigations of amniotic
fluid
Sperling et al. 1991
Berlin West
Sharp increase after 9
months
Sperling et al. 1991,
1994
108
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Table 5 Observed health defects in children after in utero exposure by the Chernobyl
accident except malformations and Downs´s syndrome
Belarus
Selected regions
Mental disorders
Speech-language
disorders, mental
retardation
Kondrashenko et al. 1996
Kolominsky et al. 1999
Kulakov et al. 1993
Chechersky District
near Gomel
Diseases of respiratory
organs, blood,
circulation etc.
Stolin District in
Brest region
Diseases of respiratory
organs, glands, blood,
circulation, digestive
organs
Belarus, Ukraine,
Russia
Mental retardation and
other mental disorders
Kozlova et al. 1999
Diseases of respiratory
organs, blood,
circulation etc.
Kulakov et al. 1993
Ukraine
Polessky District near
Kiev
Rovno Province
Childhood morbidity
Immigrants to Israel
from contaminated
areas
Asthma
Sychik, Stozharov
1999a,b
Ponomarenko et al. 1993
Kordysh et al. 1995
Estimated exposures from the Chernobyl accident
In spite of the overwhelming evidence of effects observed also in countries far away from
the Chernobyl event they are ignored by international radiation protection committees.
They assume that the exposures of the population are much too low to generate teratogenic
effects. Indeed, the physical dose estimates resulted in mean effective life-time exposures in
large regions of Europe and in Turkey below 1.2 mSv (UNSCEAR 1988). The highest
average dose for a sub-region in the first year after the accident is derived to 2 mSv in
Belarus.
These estimates show, however, large discrepancies in comparison with biological
dosimetry. Investigations of unstable and stable chromosome aberrations in the
lymphocytes of persons in the contaminated regions have been carried out by a variety of
research groups in rather large collectives directly after the accident or some years later.
Dicentric chromosomes can be considered as radiation-specific and most sensitive because
of their very low and nearly constant rate in unexposed persons (Hoffmann and SchmitzFeuerhake, 1999).
It is generally found that the observed rates of dicentric chromosomes after Chernobyl
are considerably higher – by 1 or 2 orders of magnitude – than would be expected from
physically derived dose estimates. This evaluation is possible although the dose-effect
relationships in cases of incorporated radioactivity are not known. For low dose
homogenous exposure by low LET irradiation the rate of dicentrics can be considered as
109
ECRR 2006: CHERNOBYL 20 YEARS AFTER
dose-proportional which follows from studies in the range of background exposure. In
European countries, far from the Chernobyl site, the exposure of the tissues, except the
thyroid, is assumed to be mainly generated by 137Cs and 134Cs which distribute
homogenously inside the body. The whole body doubling dose for dicentrics by
homogenous low LET radiation is about 10 mSv (Hoffmann and Schmitz-Feuerhake,
1999). Elevations of dicentrics in persons which are higher than 2-fold would therefore
mean that the whole body dose exceeds 10 mSv. Such elevations have been found manifold
after Chernobyl. Findings for Austria, Germany and Norway are shown in Table 6.
A remarkable finding in many of the chromosome studies is that they report an overdispersion of the dicentrics and the occurrence of multi-aberrant cells (Bochkov and
Katosova 1994; Hille et al. 1995; Salomaa et al. 1997; Scheid et al. 1993, Sevan`kaev et al.
1993; Stephan and Oestreicher 1989; Verschaeve et al. 1993). This is an indication of a
relevant contribution of incorporated α-activity which is not considered adequately in the
physical dose estimates.
Table 6 Chromosome aberrations in lymphocytes of persons living in West European
regions contaminated by Chernobyl releases; dics = dicentric; cr = centric rings
a
mean elevation
Region
Sample
Date of
study
Method
a
Results
Reference
Salzburg
Austria
17
adults
1987
dics+cr
Ca. 4-fold
Germany
southern
regions
Norway:
selected
regions
29
children
+ adults
44
Reindee
r Samis,
12
sheep
farmers
19871991
dics+cr
Ca. 2.6fold
1991
dics+cr
10-fold
PohlRüling et
al. 1991
Stephan,
Oestreiche
r 1993
Brogger et
al. 1996
Remarks
physical dose
estimate
<0.5mSv
physical dose
estimate
5.5 mSv
Conclusions
The data in tables 2-6 show that neither the exposure of populations affected by the
Chernobyl accident nor the effects have been evaluated correctly up to now. It must be
discussed, however, that some of the authors interpret their somatic findings as genetically
induced. In cases of continual exposure by radioactivity it is, indeed, not always certain
whether the damage occurred in utero or by pre-conceptional mutation. Intrauterine deaths
and infant deaths, as well as malformations, are also inducible by irradiation of the germcells in fathers or mothers. Rugh (1962) has already stated that the appearance of certain
malformations of the brain are quite similar after pre-conceptional and in utero irradiation.
The studies of the A-bomb survivors did not show significant genetic effects.
Investigations in the offspring of a large cohort of Sellafield workers, however, which were
initiated after the leukaemia findings in the proximity of this British nuclear reprocessing
plant, confirm a rise in stillbirths and congenital anomalies caused by pre-conceptional
exposure of the fathers (Parker et al. 1999). The cited Chernobyl studies may therefore
110
ECRR 2006: CHERNOBYL 20 YEARS AFTER
include some overlap of trans-generational and teratogenic effects. Although this
conclusion demands further scientific effort for differentiation, the foetus must be
considered as vulnerable to low dose exposures as was assumed in the early times of
radiation research.
References
Akar, N., Cavdar, A.O., and Arcasoy, A., 1988, High incidence of Neural Tube defects
in Bursa, Turkey, Paediatric and Perinatal Epidemiol. 2:89-92.
Akar, N., Ata, Y., and Aytekin, A.F., 1989, Neural Tube defects and Chernobyl?
Paediatric and Perinatal Epidemiol. 3:102-103.
Bochkov, N.P., and Katosova, L.D., 1994, Analysis of multiaberrant cells in
lymphocytes of persons living in different ecological regions, Mutat. Res.
323:7-10.
Bogdanovich, I.P., 1997, Comparative analysis of the death rate of children, aged 0-5,
in 1994 in radiocontaminated and conventionally clean areas of Belarus, in:
Medicobiological effects and the ways of overcoming the Chernobyl
accident consequence, Collected book of scientific papers dedicated to the
10th anniversary of the Chernobyl accident, Minsk-Vitebsk, p. 4.
Brogger, A., Reitan, J.B., Strand, P., and Amundsen, I., 1996, Chromosome analysis of
peripheral lymphocytes from persons exposed to radioactive fallout in
Norway, Mutat. Res. 361:73-79.
Caglayan, S. Kayhan, B., Mentesoglu, S., and Aksit, S., 1990, Changing incidence of
neural tube defects in Aegean Turkey, Paediatric and Perinatal Epidemiol.
4:264-268.
Czeisel, A.E.; and Billege, B., 1988, Teratological evaluation of Hungarian pregnancy
outcomes after the accident in the nuclear power station of Chernobyl,
Orvosi Hetilap 129:457-462 (Hungarian).
Dolk, H., Nichols, R., and a EUROCAT Working Group, 1999, Evaluation of the
impact of Chernobyl on the prevalence of congenital animalies in 17
regions of Europe, Int. J. Epidemiol. 28:941-948.
Ericson, A., and Kallen, B., 1994, Pregnancy outcome in Sweden after Chernobyl,
Environ. Res. 67:149-159.
Fritz-Niggli, H., 1997, Strahlengefährdung/Strahlenschutz, 4th ed., Hans Huber, Bern,
Switzerland.
Godlevsky, I., and Nasvit, O., 1998, Dynamics of health status of residents in the
Lugnyny district after the accident of the ChNPS, in: Research activities
about the radiological consequences of the Chernobyl NPS accident and
social activities to assist the sufferers by the accident, T. Imanaka, ed.,
Research Reactor Institute, Kyoto University, KURRI-KR-21, pp.149-156.
Grosche, B., Irl, C., Schoetzau, A., and van Santen, E., 1997, Perinatal mortality in
Bavaria, Germany, after the Chernobyl reactor accident, Rad. Environ.
Biophys. 36:129-136.
Güvenc, H., Uslu, M.A., Güvenc, M., Ozkici, U., Kocabay, K., and Bektas, S., 1993,
Changing trend of neural tube defects in Eastern Turkey, J. Epidemiol.
Community Health 47:40-41.
Harjulehto, T., Aro, T., Rita, H., Rytomaa, T., and Saxen, L., 1989, The accident at
Chernobyl and outcome of pregnancy in Finland, Brit. Med. J. 298:995997.
111
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Harjulehto, T., Rahola, T., Suomela, M., Arvela, H., and Saxén, L., 1991, Pregnancy
outcome in Finland after the Chernobyl accident. Biomed & Pharmacother
45:263-266.
Hille, R., Wolf, U., Fender, H., Arndt, D., and Antipkin, J., 1995, Cytogenetic
examination of children in Ukraine, In Radiation Research 1895-1995.
Proceed. 10th Int. Congr. Radiation Res. Würzburg, U. Hagen et al., ed.,
Germany.
Hoffmann, W., and Schmitz-Feuerhake, I., 1999, How radiation-specific is the dicentric
assay? J. Exp. Analysis Environ. Epidemiol. 2:113-133.
Jacobson, L., 1966, Radiation-induced effects in mouse foetuses, Acta radiol. 254:82
Kolominsky, Y., Igumnov, S., and Drozdovitch, V., 1999, The psychological
development of children from Belarus exposed in the prenatal period to
radiation from the Chernobyl atomic power plant, J. Child. Psychol.
Psychiatry 40:299-305.
Kondrashenko, V.G. et al., 1996, Mental disorders caused by Chernobyl, in: Report on
the 3rd Int. Congress “World after Chernoby”, Minsk, 1996, cited in
Nesterenko, V.B., Chernobyl Accident. Radiation Protection of Populatio,
Republic of Belarus Institute of Radiation Safety “Belrad”, Minsk 1998.
Korblein, A., and Kuchenhoff, H., 1997, Perinatal mortality in Germany following the
Chernobyl accident, Rad. Environ. Biophys. 36:3-7.
Körblein, A., Säuglingssterblichkeit nach Tschernobyl, 2003a, Berichte Otto Hug
Strahleninstitut 24:6-34.
Korblein, A., 2003b, Strontium fallout from Chernobyl and perinatal mortality in
Ukraine and Belarus, Radiats. Biol. Radioecol. 43:197-202.
Körblein, A., 2004, Fehlbildungen in Bayern nach Tschernobyl, Strahlentelex No. 416417:4-6.
Kordysh, E.A., Goldsmith, J.R., Quastel, M.R., Poljak, S., Merkin, L., Cohen, R., and
Gorodischer, R., 1995, Health effects in a casual sample of immigrants to
Israel from areas contaminated by the Chernobyl explosion, Environ.
Health Persp. 103:936-941.
Kozlova, I.A., Niagu, A.I., and Korelev, V.D., 1999, The influence of radiation to the
child mental development, Zh. Nevrol. Psikhiatr. Im. SS Korsakova 99:1216 (Russ.).
Kruslin, B., Jukic, S., Kos, M., Simic, G., and Cviko, A., 1998, Congenital anomalies of
the central nervous system at autopsy in Croatia in the period before and
after Chernobyl, Acta Med. Croatica 52:103-107.
Kulakov, V.I., Sokur, T.N., Volobuev, A.I., Tzibulskaya, I.S., Malisheva,V.A., Zikin,
B.I., Ezova, L.C., Belyaeva, L.A., Bonartzev, P.D., Speranskaya, N.V.,
Tchesnokova, J.M., Matveeva, N.K., Kaliznuk, E.S., Miturova, L.B., and
Orlova, N.S., 1993, Female reproduction function in areas affected by
radiation after the Chernobyl power station accident, Environ Health Persp.
101, Suppl. 2:117-123.
Lazjuk, G.I., Nikolaev, D.L., and Novikova, I.V., 1997, Changes in registered
congenital anomalies in the Republic of Belarus after the Chernobyl
accident, Stem Cells 15, Suppl. 2:255-260.
Lotz, B., Haerting, J., and Schulze, E., 1996, Veränderungen im fetalen und kindlichen
Sektionsgut im Raum Jena nach dem Reaktorunfall von Tschernobyl, Oral
presentation at the International Conference of the Society for Medical
Documentation, Statistics, and Epidemiology, Bonn, Germany (available on
request).
112
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Lüning, G., Scheer, J., Schmidt, M., and Ziggel, H., 1989, Early infant mortality in
West Germany before and after Chernobyl, Lancet II:1081-1083.
Michel, C., Fritz-Niggli, H., 1977, Radiation damage in mouse embryos exposed to 1
rad X-rays or negative pions, Fortschritte Röntgenstrahlen 127:276-280.
Mocan, H., Bozkaya, H., Mocan, Z.M., Furtun, E.M., 1990, Changing incidence of
anencephaly in the eastern Black Sea region of Turkey and Chernobyl,
Paediatric and Perinatal Epidemiol. 4:264-268.
Moumdjiev, N., Nedkova, V., Christova, V., Kostova, Sv., 1992, Influence of the
Chernobyl reactor accident on the child health in the region of Pleven,
Bulgaria, in: 20th Int. Congr. Pediatrics Sept. 6-10, 1992 in Brasil, p.57.
Cited by Akar, N., Further notes on neural tube defects and Chernobyl
(Letter), Paediatric and Perinatal Epidemiol. 8, 1994, 456-457.
Ohzu, E., 1965, Effects of low-dose X-irradiation on early mouse embryos, Radiat. Res.
26:107.
Parker, L., Pearce, M.S., Dickinson, H.O., Atkin, M., Craft, A.W., 1999, Stillbirths
among offspring of male radiation workers at Sellafield nuclear processing
plant, Lancet 354: 1407-1414
Petrova, A., Gnedko, T., Maistrova, I., Zafranskaya, M., Dainiak, N., 1997, Morbidity
in a large cohort study of children born to mothers exposed to radiation
from Chernobyl. Stem Cells 16, Suppl. 2: 141-150
Pohl-Rüling, J., Haas, O., Brogger, A., Obe, G., Lettner, H., Daschil, F., Atzmüller, C.,
Lloyd, D., Kubiak, R., and Natarajan, A.T., 1991, The effect on lymphocyte
chromosomes of additional burden due to fallout in Salzburg (Austria) from
the Chernobyl accident, Mutat. Res. 262:209-217.
Ponomarenko, V.M., Nagornaia, A.M., Proklina, T.L., Litvinova, L.A., Stepanenko,
A.V., Sytenko, E.R., and Osnach, A.V., 1993, The morbidity in preschool
children living on the territory of Rovno Province subjected to radioactive
contamination as a result of the accident at the Chernobyl Atomic Electric
Power Station, Lik Sprava. 2-3:36-38 (Russ.).
Ramsay, C.N., Ellis, P.M., and Zealley, H., 1991, Down´s syndrome in the Lothian
region of Scotland – 1978 to 1989, Biomed. Pharmacother. 45:267-272.
Roux, C., Horvath, C., and Dupuis, R., 1983, Effects of pre-implantation low-dose
radiation on rat embryos, Health Phys. 45:993-994.
Rugh, R., and Grupp, E., 1959, X-irradiation exencephaly, Am. J. Roentgenol. Radium
Ther.Nucl. Med. 81:1026-1052.
Rugh, R., 1962, Major radiobiological concepts and effects of ionizing radiations on the
embryo and fetus, in Haley, T.J. and Snider, R.S., ed., Response of the
nervous system to ionizing radiation, Academic press, New York, London,
p. 3-26
Salomaa, S., Sevan`kaev, A.V., Zhloba, A.A., Kumpusalo, E., Mäkinen, S., Lindholm,
C., Kumpusalo, L., Kolmakow, S., and Nissinen, N., 1997, Unstable and
stable chromosomal aberrations in lymphocytes of people exposed to
Chernobyl fallout in Bryansk, Russia, Int. J. Radiat. Biol. 71:51-59.
Savchenko, V.K., 1995, The Ecology of the Chernobyl Catastrophe. Scientific outlines
of an international programme of colloborative research. Man and the
Biosphere Series Vol. 17, UNESCO Paris, p.83.
Scheid, W., Weber, J., Petrenko, S., and Traut, H., 1993, Chromosome aberrations in
human lymphocytes apparently induced by Chernobyl fallout, Health Phys.
64:531-534.
113
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Scherb, H., and Weigelt, E., 1999a, Spatial-temporal logistic regression of the cesium
contamination and the time trends in annual stillbirth proportions on a
district level in Bavaria, 1980-1993, in: Proceedings of the 14th
international workshop an statistical modelling, H. Friedl et al., ed.,
Technical University Graz, Graz, Austria, pp.647-650.
Scherb, H., Weigelt, E., and Brüske-Hohlfeld, I., 1999b, European stillbirth proportions
before and after the Chernobyl accident, Int. J. Epidemiol. 28:932-940.
Scherb, H., Weigelt, E., Brüske-Hohlfeld, I., 2000a, Regression analysis of time trends
in perinatal mortality in Germany, Environ. Health Persp. 108:159-165.
Scherb, H., Weigelt, E., 2000b, Spatial-temporal change-point regression models for
European stillbirth data, in: 30th Ann. Meeting Europ. Soc. Radiat. Biol.,
Warszawa,
Poland,
August
27-31,
Abstracts,
p.14.
http://www.tschernobylhilfe.ffb.org/dokumente/warschau.pdf
Scherb, H., and Weigelt, E., 2003, Congenital malformation and stillbirth in Germany
and Europe before and after the Chernobyl nuclear power plant accident,
Environ. Sci.& Pollut.Res. 10 Special (1):117-125.
Scherb, H., and Weigelt, E., 2004, Cleft lip and cleft palate birth rate in Bavaria before
and after the Chernobyl nuclear power plant accident, Mund Kiefer
Gesichtschir. 8:106-110 (in German).
Sevan´kaev, A.V., Tsyb, A.F., Lloyd, D.C., Zhloba, A.A., Moiseenko, V.V., Skrjabin,
A.M., and Climov, V.M., 1993, ´Rogue`cells observed in children exposed
to radiation from the Chernobyl accident, Int. J. Radiat. Biol. 63:361-367.
Shidlovskii, P.R., 1992, General morbidity of the population in districts of the Brest
region. Zdravoohranenie Belorussii (Minsk) 1:8-11 (Russ.).
Sperling, K., Pelz, J., Wegner, R.-D., Schulzke, I., and Struck, E., 1991, Frequency of
trisomy 21 in Germany before and after the Chernobyl accident, Biomed.
Pharmacother. 45:255-262.
Sperling, K., Pelz, J., Wegner, R.-D., Dörries, A., Grüters, A., and Mikkelsen, M., 1994,
Significant increase in trisomy 21 in Berlin nine months after the Chernobyl
reactor accident: temporal correlation or causal relation relation? Brit. Med.
J. 309:158-162
Stephan, G., and Oestreicher, U., 1989, An increased frequency of structural
chromosome aberrations in persons present in the vicinity of Chernobyl
during and after the reactor accident. Is this effect caused by radiation
exposure? Mutat. Res. 223:7-12.
Stephan, G., and Oestreicher, U., 1993, Chromosome investigation of individuals living
in areas of Southern Germany contaminated by fallout from the Chernobyl
reactor accident, Mutat. Res. 319:189-196.
Strahlentelex 55, 1989, Säuglinge starben vermehrt oder wurden tot geboren, Berlin,
Germany, p. 6.
Sychik, S.I., and Stozharov, A.N., 1999, Analysis of morbidity of children irradiated in
utero as a result of Chernobyl accident, Zdravoohranenie Belorussii (Minsk)
6:20-22 (Russ.).
Sychik, S.I., and Stozharov, A.N., 1999, Estimation of the influence of prenatal
irradiation on functional state of critical organs and systems in children at
distant terms following the Chernobyl accident. Radiats. Biol. Radioecol.
39:500-504 (Russ.).
Ulstein, M., Jensen, T.S., Irgens, L.M., Lie, R.T., and Sivertsen, E., 1990, Outcome of
pregnancy in one Norwegian county 3 years prior to and 3 years subsequent
to the Chernobyl accident, Acta Obstet. Gynecol. Scand. 6:277-280.
114
ECRR 2006: CHERNOBYL 20 YEARS AFTER
UNSCEAR: United Nations Scientific Committee on the Effects of Atomic Radiation,
1986, Genetic and Somatic Effects of Ionizing Radiation, Report to the
General Assembly, New York 1986.
UNSCEAR: United Nations Scientific Committee on the Effects of Atomic Radiation,
1988, Sources, Effcts and Risks of Ionizing Radiation, Report to the
General Assembly, New York 1988.
Verschaeve, L., Domracheva, E.V., Kuznetsov, S.A., and Nechai, V.V., 1993,
Chromosome aberrations in inhabitants of Byelorussia: consequence of the
Chernobyl accident, Mutat. Res. 287:253-259.
Zieglowski, V., and Hemprich, A., 1999, Facial cleft birth rate in former East Germany
before and after the reactor accident in Chernobyl, Mund Kiefer
Gesichtschir. 3:195-199 (in German).
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
116
ECRR 2006: CHERNOBYL 20 YEARS AFTER
CHAPTER 7
Reflections of the Chernobyl Catastrophe on the Plant World:
Special and General Biological Aspects
D.M.Grodzinsky
Ukrainian National Academy of Sciences
Over the past two decades we have become increasingly aware of the long-term impact of
environmental radioactivity resulting from the accident at the Chernobyl Nuclear Power
Plant. Interest in the reaction of plants to the influence of chronic irradiation in low doses
has quickened with time because of concerns relating to a possible degradation of biota in
the areas contaminated with radionuclides.
In addition, a view of the radiobiological processes induced in plants by chronic
irradiation should elucidate the main tendencies in the formation of late effects of
irradiation. As this takes place we bear in mind that these late effects in plants could not be
related to ‘radio-phobia’, as it is called, as there is a tendency to assign the cause of injuries
observed after the Chernobyl catastrophe merely to a fear of irradiation. We have seen,
since the accident, clear and diverse effects of irradiation in plants over time (1; 2).
Emissions containing a huge total amount of radionuclides from the destroyed
reactor unit caused a vast radioactive anomaly over a large area. The doses of irradiation
varied over a wide range where radionuclides, resulting from the Chernobyl catastrophe,
were deposited. The surface activity of radionuclides reached hundreds of thousands of
Curies per square km in the immediate vicinity of the blasted reactor unit (1).
The formation of dose loads in plants is, by nature, different at various time
periods after the emergence of radionuclides within the ecosystems. We recognized various
periods in dose accumulation by plants. The first period lasted from 26 April 1986 till 15th
of May 1986 and differs from the others in that the main sources of irradiation were related
to short-lived radionuclides contained in radioactive clouds. Radionuclides were deposited
on the surfaces of leaves, soil and water. As this took place, layers of absorbed
radionuclides were fused (arrized) onto the surfaces of plant organs. Most of this
radioactivity was concentrated in "hot particles", as they are called, although there were
radionuclides in different physicochemical forms, including ionic forms. The components
of plant irradiation, during the first period, were external irradiation from radionuclides
distributed on ambient objects as well as irradiation from radioactive materials adsorbed by
the outer cell layers of plant organs. The external irradiation was largely connected with
gamma rays, but the applicative irradiation consisted of various types of radiation - gamma
rays, beta- and alpha particles. Some activity of soluble radionuclides was concentrated in
the cells and tissue of plants as the cells metabolized them (3).
The accumulated local dose under hot particles was so huge that the cells died and
some microfunnels became fused (arrized). Because of this, the hot particles held securely
onto the surfaces of leaves and other parts of the plants. In addition to this, the hot particles
held owing to gluey substances and trichomes on leaf and bud surfaces. Assessment of
doses showed that the absorbed dose for critical organs, namely apical meristems in cereal
plants growing in plots contaminated with radionuclides, ranged from 1.33 to 12 Gy in
1986 when the surface density of radionuclide contamination varied from 1,18 to 8,4 x 108
Bq per m2 (2).
The second period of irradiation (after May 1986 - over the course of the growing
season) has been related to radiation from long-lived and a few specific short-lived
radionuclides. The main components of irradiation were due to radio nuclides absorbed
onto the surfaces of plant organs and internal irradiation from radionuclides accumulated
within cells and tissues. Finally, the third period is characterized by progressive increase in
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the fraction of internal radiation resulting from long-lived radionuclides accumulated by
plants from soil through mechanisms of mineral nutrition (4).
On the whole, the dose load characteristics of different species of plants
fluctuated. General sources of the components of the dose are shown below.
Vital forms of plant
Sources of irradiation
Perennial plants which
were formed before 1986
and had developed leaves
at the time of the
accident
Acute irradiation during the
first days after the accident.
External irradiation from radioactive
clouds and deposited radionuclides.
Applicative irradiation
Critical organs:
Cells of young leaves, meristems
in developing buds
Perennial plants which
were formed before 1986
and had not developed
leaves by the time of
the accident.
Acute irradiation during the first
days after the accident
Applicative irradiation.
External irradiation
Critical organs:
Meristems of buds
Annual plants which began
development before the
accident.
chronic external irradiation
Applicative irradiation
Chronic internal irradiation
Plants, which began their
development after 1986
Chronic internal irradiation
related to root intake of longlived radionuclides
Chronic external irradiation
The territory around the Chernobyl Nuclear Power Station, especially the 10-km
zone is characterized by very high levels of dose. Conifers growing in some places of this
territory died out shortly after the accident. This dead forest was named the "Red Forest".
The lethal dose for conifers is approximated 80 -100 Gy (5).
However, lethal outcomes in plants were observed only in some areas
contaminated by large amounts of radionuclide activity. Cumulative impacts of chronic
irradiation in low doses are much more important for the comprehension, assessment and
prognosis of the late effects of irradiation on human beings, other living entities and
biocenosis.
Various plant reactions to the influence of chronic irradiation can be observed in
the neighborhood of the Chernobyl Nuclear Power Station. Among these are a high death
rate of plant apical meristems, multiple distortion of metabolism, cytogenetic effects and
various morphological abnormalities. The types and frequencies of these effects vary with
irradiation doses.
It is well to bear in mind that there is a difference in the responses of plants to
internal and external irradiation. The effectiveness of internal irradiation related to the
radionuclides deposited within cells and tissue is much higher compared with the external
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irradiation of the same rays. Table 1 gives the data illustrating the impacts of internal and
external irradiation on frequencies of gene reversion in barley pollen (6; 7).
Table 1 Frequencies of waxy reversions in barley pollen as a result of 55 days of
exposure to various levels of radionuclides released at Chernobyl and a pure gamma field.
Dose rate,
μSv.h-1
Control
(0.96)
59
320
400
515
Background
(0.11)
5
50
500
5000
50000
Total dose,
MSv
Total reversion
frequency per 106
pollen grains
Radionuclide contaminated conditions
1.3
174
75
422
528
680
0.1
3.0
29.6
296
2960
29600
226
837
1235
1705
Chronic gamma irradiation
82
145
150
198
192
292
Radiation-induced
reversions per 106
pollen grains
0
52
663
1061
1531
0
63
68
116
110
210
The large distinction of irradiation effects between internal and external irradiation can be
attributable to at least two causes. On the one hand, the relative biological effectiveness of
internal irradiation by virtue of peculiarities of microdosimetry in tissue and cells can be
much higher than in the case of external irradiation and, on the other hand, low doses of
irradiation can be perceived as a certain alarm signal. There is abundant evidence
supporting the effect of irradiation dose as a signaling factor in the response of plants to
low doses of gamma irradiation. This factor induces active responses in plants directed
towards an adaptation to chronic irradiation. It appears that there are two adaptive strategies
to stress impacts in plants, namely, ontogenetic and population or phylogenetic adaptation.
The first type of adaptive strategy is revealed by radioadaptation and resides in an
augmentation of radioresistance after irradiation in low doses. The second type of adaptive
strategy lies in an increase in frequency of genetic diversification, which enlarges the
possibilities for active natural selection.
The mechanism of ontogenetic adaptation involves an induction of synthesis of
additive enzymes concerned with DNA reparation. We have suggested that ontogenetic
radioadaptation is a nonspecific response of plants and the synthesis of additive reparative
enzymes may result from the action of not only ionizing radiation, but also by factors of
another nature, for instance UV-B (8). Most likely the ontogenetic adaptive strategy
operates as a source for sustaining the organism within modified environmental conditions
marked by an increase in genotoxicity. Widening the diversification of plant forms in future
generations is achieved by means of genome instability in response to irradiation in low
doses.
It is reasonably safe to suggest that many of the plant responses to low level
chronic irradiation may be considered as a consequence of the active reactions of plants
associated with the realization of adaptive strategies.
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Teratogenicity in Plants in the Zone of low dose chronic Irradiation
A marked alteration of morphogenesis in plants growing within territories contaminated by
radionuclides has been noted. Commonly encountered radiomorphoses derives from
stochastically distributed cells, which have lost the capability for division. Inactivated cells
restrict the normal behavior of intact cells in respect of division and elongation.
Malformations are developed as a consequences of these restrictions. Examples of
radiomorphoses in oak and horse chestnut leaves are shown in Fig.1 and 2.
Fig. 1 Giant leaf of irradiated oak (Quercus robur) with some deformation of the leaf plate
(right) and normal leaf from unirradiated tree.
Fig. 2. Typical radiomorphose in horse-chestnut (Aesculus hippocastanum)
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
It can be seen clearly that the formation of leaves in these trees vary considerably in shape.
However, there exist two types of abnormalities of morphogenesis. Altered organs are
occasionally characterized by a regularity of structure – these differ in structure
considerably to normal organs but are rigorously regular. The other type of altered organs
are deformed in their structure without any regularity. The "regular radiomorphoses" were
precisely the forms more frequently encountered in plants growing within contaminated
territories. In fig. 3 gigantic needles in spruce (Picea abies) are shown. The metamorphosed
needles are located in the upper part of the stem. The sizes of these needles were eight-ten
times larger then in the unirradiated control plants.
Fig.3. Metamorphosed needles in spruce (Picea abies) grown in the Alienated Zone of the
Chernobyl Nuclear Power Station. Twig with gigantic needles in the upper part (left),
Normal and metamorphosed twigs (right).
Accretion of plant organs, notably flowers, were of frequent occurrence. Remarkably, this
has occured in parts of the plant which do not normally branch out, for example: in the
pedicle of the common dandelion (Taraxacum officinale).
It seems likely that the extent to which the morphological malformations can be
manifested does not depend on dose rate, but the frequency of its formations are strongly
dependant on the overall doses of chronic irradiation. We observed very expressive and
cognate morphological malformations in plants growing in Kiev where the dose rates were
substantially below those in the Alienated Zone (2).
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In this respect the manifestations of morphological malformations are similar to
the stochastic process when deviations of growth from the norm follow the all-or-none
principle.
Fig.4. Pine (Pinus silvestris) with a great excess of apices.
This type of morphological anomaly owes its origin to the deterioration of the mechanism
of apical dominance. Excess of ramification observed in many plant species is conditioned
also by this reason. The effect of an excess of "unscheduled" tops is seen clearly in Fig.4.
An excess of lateral buds in irradiated spruce are shown in figure 5.
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Fig.5. Extraordinary localization of buds in spruce twig.
One observation, which may be a guide to the nature of this mechanism, is that the gravity
perceiving organ appears to be impaired - resulting in the loss of normal orientation. (6).
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Fig. 6. Loss of gravitational orientation in spruce (Picea abies)
Surviving in the Chernobyl Zone.
The cross section of needles was also altered, becoming round rather than kidney-shaped. A
number of needles in one fascicle were larger than the norm. On occasion, a great excess of
needles were formed and the stem was cluttered with a dense brush of needles (Fig. 7)
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Fig.7 Dense location of extraordinary dying needles in pine
"Brushes" of this kind were located in various parts of the stem, usually in the apical tops.
This interesting phenomenon is the result of a proliferation of the primordia of the scales
attempting to form full needles. It is not an example of “radiophobia”.
Gigantism in leaves has been accompanied by augmentation in the sizes of
anatomical elements. This is shown in Fig 8.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Fig. 8. Anatomical structure of abnormally enlarged needles in spruce.
We photographed regular radiomorphoses in various perennials, as well as in annual plant
species in the first years after the accident at the Chernobyl Nuclear Power Plant, but
morphological anomalies can also be observed in the Alienated Zone in recent years. Table
2 demonstrates the characteristics of needles in conifers in recent years (9).
Table 2. Morphometric indicators of control and chronically irradiated pine (Pinus
silvestris) and spruce (Picea abies)
Plant
Pine, control
Median length of
needles, mm
60+4
Median weight of
needle, mg
80+3
Pine, chronic irradiation
19+3
14+2
Spruce, control
16+2
5+1
Spruce, chronic irradiation
40+3
95+5
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Regular morphological abnormalities in plant structure may be classified in the following
manner:
Type of morphological
abnormalities
Irregular radiomorphoses
Gigantism in leaves
Dwarfism in leaves
Polyapices
Formation of extraordinary apical
and lateral buds
Formation of additional
extraordinary needles in the stems
of conifers
Loss of geotropic orientation of
organs
The surplus of ramification
Primary causes of abnormalities
Proliferation of dead of meristematic cells
stochastically distributed in tissue
Alteration of the positional control in
meristem (increased number of quantal
mitosis)
Alterations of positional control in meristem
(decreased number of quantal mitosis)
Removal of apical dominance in apical
meristem
Slackening of apical dominance
and alterations of positional control in the
secondary meristem
Loss of positional control in cataphyls
Slackening of polarity in organs
Slackening of apical dominance
Alterations of physiological and biochemical processes were also observed in plants
growing in circumstances where soil was contaminated with radionuclides. By way of
illustration we refer to changes of colour in thyme. It is evident that the colour of a flower is
dependant on the acidity of cell sap and from this follows the conclusion that the acidity of
the cell sap changes under chronic irradiation. It is not inconceivable that this response of
irradiated thyme also has a stochastic nature.
Mutagenic impact of irradiation in low doses on plants
Two general types of radiobiological effects in plants are recognized in cases of acute
irradiation as well as in the event of low dose chronic irradiation: non-stochastic or
deterministic and stochastic effects. Non-stochastic effects consist of somatic damages and
functional deficiencies. Stochastic effects are characterized by the probabilistic nature of its
manifestation. These effects have no dose threshold and the intensity of its manifestation
does not depend on the dose. Mutagenesis of somatic and reproductive cells is referred to as
a stochastic effect of irradiation (3).
The frequency of chlorophyll mutations was also increased by irradiation due to
radionuclide contamination (Table 3)
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Table 3. Yield of albina chlorophyll mutation (%) in rye and barley
seedlings in the 30 km zone
Years of planting in contaminated soil
1986
1987
1988
1989
Plant
Control
Rye (var. Kiev-80)
Rye (var. Kharkow03)
Barley (var. No 2)
0.01
0.02
0.14
0.80
0.40
0.99
0.91
1.20
0.71
1.14
0.35
0.81
0.63
0.70
0.71
Activity of soil:
134
Cs, 137Cs, 144Ce, 106Ru and others, 180 kBq.kg-1
The genetics effects of irradiation can be demonstrated by using some mutant
plants. In these there is an emergence of reversion forms (tables 4 – 6).
Table 4. Influence of gamma irradiation on the frequency of reversions in the mutant form
of mouse-ear cress (Arabidopsis thaliana f. Glabrous)
Dose of irradiation
Control, unirradiated plants
Acute irradiation, 10 Gy
Chronic irradiation, 0.3 Gy
Chronic irradiation, 0.5 Gy
Chronic irradiation, 5 Gy
Number of leaves
with trichomes
0
3.8+0.7
9.7 + 1.8
11.7 +1.9
12.5 + 1.5
Cladding of leaves
with trichomes, %
1.9 + 0.1
1.9 + 0.3
2.9 + 1.5
19.6 + 3.1
Table 5. Damage to cells of apical root meristem in onion (Allium cepa) growing in soil
contaminated with radionuclides
Specific
radioactivity
of soil,
kBq.kg-1
Number
of cells
under
study
Mitoti
c
index,
%
Number of
cells with
aberrations, %
in reference to
control
Control
37
185
370
15005
33275
29290
23325
4.1
4.4
4.4
117
100
240
216
150
Number of
cells with
micronuclei
% in
reference to
control
100
171
129
229
Number of
degenerating
cells % in
reference to
control
100
250
500
900
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Table 6. The manifestation frequency of various polyploid pollen cells in mouse-ear cress
(Arabidopsis thaliana)) under chronic irradiation (the first vegetation), %
Ploidy of pollen grain
Diploid cells
Tetraploid cells
Chimaeric tissue
Control,
unirradiated
plants
0.5
5
91
1
8
77
9
14
65
15
20
Dose, Gy
Data presented in these tables point to the fact of a strong influence of chronic irradiation
on cytogenetic distortions in plant cells. The effects of chronic irradiation embrace the
various genetic events from genome to point mutations.
Alterations in metabolic processes in irradiated plants
Intensities of many biochemical processes are changed in plants surviving in the Chernobyl
zone. The infringements of metabolic reactions are basically linked to a violation of
signaling systems in plants as well as protection reactions to stress. The previously
mentioned reactions are unspecific, being realized when stress factors of different a nature
influence plants. This phenomenon is illustrated by data on an augmentation of anthocyanin
concentration in plants irradiated with gamma rays or growing in a radionuclide
contaminated area (table 7)
Table 7. Content of anthocyanins in irradiated plants
Plant species
Type of irradiation
Maize (Zea mays),
seedlings
Control
Acute irradiation, 10 Gy
Chronic irradiation: plants were
grown in soil contaminated with
radionuclides,
975 Bq.kg-1
Control
Acute irradiation, 10 Gy
Chronic irradiation 0.5 Gy
Control
Acute irradiation, 10 Gy
Chronic irradiation, 0.5 Gy
Bean (Phaseolus
aureus), hypocotyl
Mouse-ear cress
(Arabidopsis thaliana
f.Columbia)
Content of
anthocyanins, % in
reference to control
100
127
119
100
123
157
100
169
173
As is obvious from these data the effect of chronic irradiation is greater than in the
controls.
Tumor formation in plants grown under low dose irradiation
Inasmuch as processes of growth and morphogenetic regulation as well as positional
control in plants are injured by irradiation, there is reason to assume that there are bound to
be reductions in the normal response to the stimuli provided by the bacterial tumor
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Agrobacterium tumefaciens. Stimulation of growth of these tumors in plants does occur
under the action of low-level irradiation. This has been demonstrated in experiments on
explants from potato tubers grown in soil extracts contaminated with radionuclides. The
specific radioactivity of these extracts was approximately 3 kBq.l-1. Stimulation of growth
in callus culture from Datura stramonium has been also established (3). Table 8 shows
tabulated data illustrating the impact of chronic irradiation on tumor tissue in jimson-weed.
Table 8. Impact of soil extracts on growth and cell divisions in normal and tumor tissue of
Datura stramonium.
Content
of variant
Weight of callus,
The average
Number of cells in
1g
of tissue,
x 105
%
39.7
100
38.9
98
The average
number of cells
in callus,
x 105
G
%
%
Control, normal tissue
1.98
100
78.6
100
Normal tissue treated
2.58
130.2
100.4
127.6
with extract from
radioactive soil
Tumor tissue
.24
100
23.0
100
74.5
100
Tumor tissue treated with 2.82
87.2
32.4
140.7
91.5
122.8
extract from radioactive
soil
(Radioactivity of soil –3.1 104 Bq.kg-1, radioactivity of soil extract – 20 Bq.l-1. Soil was
contaminated with 137Cs and 144Ce)
New tumor-like formations arise in many plant species (Hieracium murorum, Hieracium
umbellatum, Rubus idaeus, Rubus caesius and others) grown in natural conditions on
territories contaminated with radionuclides. Tumor-like nodes were found in nearly 80 %.
Of Sonchus arvense grown in contaminated soil (3).
An increase in gall formations was observed in leaves of oaks in forests
contaminated with radionuclides.
Induction of genome instability in plants
There is evidence for active cellular processes initiated by chronic irradiation in low doses
in plants. The display of the range of phenomena, namely genomic instability, bystander
effects and adaptive responses has convinced radiobiologists to consider a new supposition
regarding the contribution of radiobiological responses from active cellular processes.
Genome instability is a term used to describe an increased rate of genetic
alterations. Genomic instability, with respect to chromosomal endpoints, was first described
as the delayed onset of de novo chromosomal aberrations (10) and induction of mutations.
We have observed radiation-induced chromosomal instability in many species of
plants after their transference from radioactive soil to “Clean” substrate. These studies have
involved continuing exposure to a wide range of dose rates and observations on the late
effects of irradiation (Table 9).
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 9.Yield of chromosome aberrations (%) by chronic irradiation in root apical
meristems of different plant species*
Plant species
Control
1986
1987
1988
1989
Lupinus alba
Pisum sativum
Secale cereale
Triticum
aestivum
Hordeum
vulgare
0.9
0.2
0.7
0.9
19.4
12.9
14.9
16.7
20.9
14.1
18.7
19.3
14.0
9.1
17.1
17.7
15.9
7.9
17.4
14.2
0.8
9.9
11.7
14.5
9.8
* Seedlings were grown in a nutritive solution containing 70,000 Bq.l-1
Genome instability induced by chronic irradiation in low doses can be best observed in the
behavior of winter wheat plants in our "Collection of Chernobyl Wheat Mutants". This
collection originated with genetically modified plants gathered in 1987 in the neighborhood
nearest to the wrecked reactor unit (11). Fields of winter wheat were located in territories
characterized by high levels of radioactivity. The plants were exposed to severe irradiation
from radioactive clouds, radionuclides were absorbed into the surfaces of organs in 1986
and from inner sources of radiation due to incorporated radionuclides in 1987. Ears of
wheat have fallen and compact families originating from each ear developed in the autumn
of 1986. There were many morphologically changed forms. The famous wheat selectionists
Prof. Shkvarnikov P.K. and Prof. Batygin N.F. gathered seeds of severely modified wheat
plants. These seeds were sown in clean territory in the autumn of 1987. Beginning in that
year and up to this point, the genetic behavior of these plants has been exemplified by an
uninterrupted, continuous change. Variability of the morphological characteristics is very
wide, year after year, covering ear form, height of ears and plants, presence of awnes,
glumes, physiological and biochemical peculiarities, including ripeness, quality of gluten
and other characteristics. The variability of mutants in the collection is very intensive and
unpredictable.
In Table 10 frequency of the main morphological anomalies in winter wheat are
demonstrated.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 10. The frequency of morphological anomalies in three generations of winter wheat
grown over two years in highly contaminated fields
Type of morphosis
Zones of sterility in ear
Shortening of ear
Ramification of ear
Shortening of stem
Lengthening of stem
Augmentation of awns
Unevenness of awns
Square-headed forms
Altered colour of stem
Gigantism in ear
Additional earlets
Years of investigation
1986
1987
1988
49.0
29.8
1.9
10.0
9.4
0.8
4.5
11.1
9.4
4.5
5.7
4.9
4.4
4.7
5.4
2.8
2.8
4.7
1.4
3.4
2.9
4.9
14.0
24.7
0.9
1.7
1.9
1.4
1.8
2.9
14.0
14.8
29.7
The extensively widespread morphological modifications among the plants in the
collection are shown in Fig. 9.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Fig 9. Diversified forms of ears in winter wheat showed evidence of significant
genome instability.
Radiation-induced genome instability is apparently connected with a specific mechanism.
Several groups have demonstrated that proteins associated with the repair of DNA may
contribute to the instability process, such as DNA-Pros and p53 (10). Certain DNA repair
proteins have been shown to take part in the protection of telomeres (10). Cells having
mutations in genetic coding for these proteins are subject to multiple forms of instability defective double-strand break repair, chromosomal end-to-end fusion, and joining of
unprotected telomeres to the radiation-exposed ends of the double-strand breaks. It is
conceivable that epigenetic alterations (changes in methylation, acetylation, and
phosphorylation) may also be responsible for the induction of instability in the phenotype
(10).
From these numerous facts it is apparent that radiobiological responses are
manifested with high intensity on various levels of plant systems organization. Relative
biological effectiveness of chronic irradiation is very high especially for internal irradiation.
The types of effects from chronic irradiation differ in significant ways from radiobiological
responses of plants under acute irradiation. Late effects of irradiation play an increasingly
important part in the augmentation of risk for biota on the territories contaminated with
radionuclides. These essentially genetic effects can be very dangerous for plant individuals
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
and populations. It is not inconceivable that, aside from the injuring influence of chronic
irradiation, there is a signal impact within this factor on living beings and a system of
responses has to be manifested as an integral adaptive reaction. Induction of genome
instability, changes of reaction norms, widening of the spectrum of phenotypes, an increase
in the frequency of mitotic cross-over and induction of unscheduled apoptosis in meristem
are all components of this perverse adaptive reaction of organisms.
The radiobiological effects, which have been investigated in plants growing in
territories contaminated with radioactive substances, do not, indeed, pertain only to plants:
They are applicable for all living beings, as common principles form the basis of these
radiobiological responses. The menace from the Chernobyl Catastrophe has not grown dim:
It is with us and will be around for a long time.
References
1. Chernobyl Catastrophe/ Ed. By V.G. Baryakhtar. - Kiev: Editorial House of Annual
Issue "Export of Ukraine", 1977. -576 p.
2.Chornobyl. The Exclusion Zone. Collected Papers. (Ed. V.G. Baryakhtar. -Kiev:
Naukova Dumka, 2001. -548 P. (in Russian).
3. Grodzinsky, D.M., Kolomietz, O.D., Kutlachmedov, Yu.A. Anthropogenic Anomaly and
Plants. -Kiev: Naukova dumka, 1991, 160 P. (in Russian).
4. Grodzinsky, D.M. Consequences of the Chernobyl Catastrophe as a Prototype of Nuclear
Terrorism. - Defense and the Environment: Effective Scientific Communication
(Eds. K.Mahutova et al. Kluwer Academic Publishers, 2004. - P.119 - 137.
5. Kozubov, G.M., Taskaev, A.I. Radiobiology Investigations of Conifers in Region of the
Chernobyl Disaster (1986 - 2001). Moscow: PPC "Design. Information.
Cartography", 2002. -272 P.
6. Bubryak, I., Vilensky, E., Naumenko, V., Grodzinsky, D. Influence of Combined Alpha,
Beta and Gamma Radionuclide Contamination on the Frequency of Waxyreversions in Barley Pollen.// Sci. Total Environ., 1992, 112, 29 - 36 P.
7. Grodzinsky, D.M. Late Effects of Chronic Irradiation in Plants after the Accident at the
Chernobyl Nuclear Power Station// Radiat. Protect. Dosimetry, 1995, 62, p. 41 43.
8. Danil’chenko O.O., Grodzinsky D.M. Participation of DNA reparation systems in
forming of radiation adaptive reaction in plants / in: Paradigms of contemporary
radiobiology; Radiation protection of personnel of the objects of atomic
energetics. – Kiev: Chernobyl, 2004. P. 15 – 16.
9. Sorochinsky B.V. Peculiarities of protein contents in abnormal needles in spruce (Picea
abies) and pine (Pinus silvestris) from 1-km Zone of Chernobyl Nuclear Power
Plant// Cytology and Genetics, 1998, vol. 32, No 5, P. 35 – 40.
10. Kadhim, M.A., Moore, S.R., Goodwin, E.H. Interrelationships amongst RadiationInduced Genomic Instability, Bystander Effects, and the Adaptive Response //
Mutation Research, 2004, 568, p. 21 - 32.
11. Grodzinsky D.M./ Kolomietz O.D., Burdenjuk L.A. Collection of Chernobyl Mutants
of Winter Wheat. –Kiev< 1999. – 30 p. (In Ukrainian).
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CHAPTER 8
Infant Leukaemia in Europe after Chernobyl and its Significance for
Radioprotection; a Meta-Analysis of Three Countries Including New Data
from the UK.
Chris Busby
University of Liverpool, UK
Green Audit, UK
[email protected]; [email protected]
1. Background
The Chernobyl accident contaminated most of Europe (Savchenko 1995) with fission
product radioisotopes including short-lived, high-activity Iodine and Tellurium, and also
fuel particles containing uranium and other intermediate half-life isotopes, including the 30
year half life Caesium-137. In the UK, whole body monitoring showed the persistence of
Caesium-137 in the population (Etherington and Dorrian 1991) and grassland surveys
enabled the radiological modelling of equivalent dose. In general, the exposures in Europe
were examined in some detail and doses to the population were well characterised. For all
of the countries of Europe except Belarus, the first year average committed effective doses
were well below 1 mSv and in the non-Soviet countries less than 0.3mSv. At these levels,
the risk models of the International Commission on Radiological Protection (ICRP) predict
no measurable health effects. The doses are less than a quarter the natural background dose,
and if dose has any universal radiological meaning, the exposures must be considered safe.
Nevertheless, there were reported health effects. The most clear and graphic set of effects
was the reported increases in infant leukaemia in the in utero exposed cohort in Greece
(Petridou et al, 1996) , Germany (Kaletsch et al 1997) and Wales and Scotland (Gibson et
al 1988, Busby and Scott Cato 2000, 2001).
Busby and Scott Cato examined the likely doses to the children and applied the
current radiation risk models of the ICRP, those employed also by all radiological
protection legislation, to show that the risk factors currently being employed for the
protection of members of the public were in error by upwards of 100-fold. Such an error
would begin to explain other apparently inexplicable associations between childhood
leukemia and exposure near nuclear sites, notably the ongoing child leukaemia cluster near
the UK Sellafield reprocessing plant in Cumbria. The importance of the infant leukaemia
results are that the doses were well characterised and that, since the cohort is so well
described, there is really no other explanation for the finding. Thus the existence of the
effect may be taken as prima facie evidence of the failure of the ICRP model and may be
used to determine the accurate risk factors for this kind of internal exposure.
The seriousness of this matter led, in the UK, to the formation of the Committee
Examining Radiation Risk from Internal Emitters CERRIE. This was set up in 2001 at the
joint request of the UK Minister of the Environment (Mr Michael Meacher) and Minister of
Health (Ms Yvette Cooper). CERRIE’s remit was to examine the assertion that, for internal
exposures from fission–product radioisotopes, the true risk factors for cancer and leukaemia
were much greater than those currently employed by the radiation protection legislation.
The ICRP model was largely based on the historical external radiation exposure studies,
principally that of the Japanese A-bomb survivors. On the other hand, by 2003, the new
European Committee on Radiation Risk (ECRR) had published its model, which attempted
to deal pragmatically with the clear evidence from various epidemiological and theoretical
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
sources that internal exposures could, in certain cases, represent enhanced risks of up to
three orders of magnitude or more (ECRR2003).
As part of its remit to examine the issue, CERRIE applied to the Oxford-based
Childhood Cancer Research Group (CCRG) in order to follow up the Busby and Scott Cato
analysis (which was for Scotland and Wales) by examining the UK by contamination area
and period. Data limitations had forced Busby and Scott Cato (2000) to employ very
slightly different periods to those used by Petridou et al. (1996) and Kaletsch et al (1997)
and CERRIE decided to obtain data for the same periods. The first question was whether
there was an effect in the high and intermediate exposure areas of the UK if the time
periods used by Petridou et al. were used to define exposure cohorts. Exposure in the UK
depended upon rainfall at the time and areas were agreed on the basis of measurements
made by the UK National Radiological Protection Board and supplied to CERRIE. In this
paper, because CCRG supplied a set of data that was for exactly the same cohort as that
examined by Petridou et al in Greece and Kaletsch et al in Germany, I combine the three
populations and weighted doses into one meta-analysis, which I employ to examine the
risks of infant leukaemia from this type of internal exposure compared with the best
available external exposure data, that of the Oxford Series obstetric X-ray studies
(Wakeford and Little 2003).
The CCRG, Greek and German Data
To try and answer the questions relating to the UK exposures, numbers of infant leukemias
(0-1yr) were obtained from the Childhood Cancer Research Group (CCRG) in Oxford for
three areas and various periods before and after Chernobyl, together with total births
occurring in these areas and periods. Two analyses were agreed. Both were aimed at
examining the hypothesis that infant leukaemia rates had been increased following
exposure in utero to radiation from the Chernobyl accident fallout in the UK. To this end,
the UK was divided into three groups of areas considered to be high, intermediate and low
exposure. Two sets of periods were also defined. The first was to enable an analysis of the
periods used by Petridiou et al. in her analysis of the effects in Greece (Petridou et al.,
1996). The second was specified by CERRIE to examine a longer time period than that
available to Petridou et al.. Although this second period analysis gave a larger effect, in this
paper I wish only to examine the Petridou period, since I can combine these data with the
earlier results.
In order to carry out such a meta-analysis I use data from Petridou et al and
Kalestch et al, given in Table 4.
Table 1. Time periods for which data on infant leukaemia were supplied by CCRG
Cohort Group code
Time period
Petridou et al analysis periods
A
01/01/80 to 31/12/85
B
01/07/86 to 31/12/87
C
01/01/88 to 31/12/90
In utero exposure
Unexposed
Exposed
Unexposed
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 2. Data from CCRG on number of infant leukaemia cases.
1st analysis (time periods as Petridou) Males+Females
Period
01/01/1980 to
31/12/1985
01/07/1986 to
31/12/1987
00/01/1988 to
31/12/1990
Total
High
3
Exposure category
Medium
Low
52
66
Total
121
1
16
24
41
2
39
35
76
6
107
125
238
Table 3 Births in the analysis periods from CCRG
(time periods as Petridou) Males+Females
Period
01/01/1980 to
31/12/1985
01/07/1986 to
31/12/1987
00/01/1988 to
31/12/1990
Total
High
90027
Exposure category
Medium
Low
1783873
2363521
Total
4237421
23152
479996
608921
1112069
47971
997941
1236102
2282014
161150
3261810
4208544
7631504
Table 4 Infant leukaemia in UK Greece and Germany in the Chernobyl in utero exposure
periods, (with rates per 100,000 and mean population-weighted foetal doses).
Mean Dose
(mSv)
0.02
d
a
Period
unexposed
121 (2.86)
4237421
83 (2.30)
A
Period B
Exposed
41 (3.69)
1112069
35 (3.76)
Period C
unexposed
76 (3.33)
2282014
60 (2.96)
UK all cases
UK births
b
Germany all 0.1
cases
3601176
928649
2029613
Germany births
c
22 (2.75)
12 (7.35)
9 (2.89)
Greece
all 0.2
cases
801175
163337
311391
Greece births
0.067
226 (2.62)
88 (3.99)
145 (3.13)
All 3 all cases
8639772
2204055
4623018
All 3 births
a
from CCRG; bfrom Kaletsch et al; c from Petridou et al.; d from original data, furnished
by NRPB for CERRIE
3. Method
Throughout this analysis I employ the same method that is used by the earlier researchers. I
use standard contingency table analysis to compare unexposed (periods A + C) with
exposed (B) cohorts. I combine all the UK categories; high, medium and low. I calculate
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
relative risks, confidence intervals and significance based on Mantel Haenszel Chi-Square
statistics for various groups in the UK and then for the combined dataset. I then examine
the predictions of the risk factors derived from the obstetric X-ray series (Wakeford and
Little 2003) with the excess risk found to calculate an error factor for the application of the
obstetric X-ray risks and also the ICRP model risk.
4. Results
In the United Kingdom, the fallout from Chernobyl was patchy and related to outbreaks of
thundery rain that occurred in Scotland, Wales and Yorkshire. Consequently, the low
exposure areas defined for the CCRG data, mainly southern Britain, received little
exposure. The high exposure areas were quite small in population and therefore I have
combined the high and intermediate exposures groups for an examination of the effect in
the UK, although for the combined analysis I use the entire UK dataset. In Table 5 I show
the relative risk for the combined high and intermediate exposure cohorts in the periods of
exposure relative to the period of no exposure. In Table 6 I combine all the UK groups with
the German and Greek groups to give a comparison of the exposed and unexposed groups
in the combined database of the three countries.
Table 5. Statistics of infant leukaemia rates in the UK based upon high + intermediate
exposure groups in Scotland, North Wales and Yorkshire. Comparison of exposed (B) and
unexposed (A+C) periods after Petridou et al.; data from CCRG.
Data Period
A
B
C
Statistics. B vs (A + C)
Cases
Population
High + Intermediate
High + Intermediate
(rates)
69 (2.8)
2453548
25 (4.0)
632073
37 (2.9)
12840973
Relative Risk 1.4 (95% C. I. 0.88< RR< 2.20)
χ2 = 2.26; p = 0.132; two tailed
Table 6. Statistics of infant leukaemia in the combined population of UK, Germany and
Greece using all UK data from CCRG plus the other data from Petridou et al 1996 and
Kaletsch et al 1997
Data Period
A
B
C
Statistics. B vs (A + C)
Cases
Population
High + Intermediate
High + Intermediate
(rates)
226 (2.62)
8639772
88 (4.0)
2204055
145 (3.1)
4623018
Relative Risk 1.43 (95% C. I. 1.13< RR< 1.80)
χ2 = 9.1; p = 0.0025; two tailed
5. Discussion
Errors in employing external radiation risk factors
In the UK data, supplied by CCRG, and based upon the Petridou et al 1996 birth cohort
criteria, there was an increase in infant leukaemia in the exposed cohort in both the high
and intermediate group and in the total population. Unlike the increases in Scotland and
Wales found by Busby and Scott Cato 2000, this increase fell short of statistical
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
significance at the p = 0.05 level using a two tailed test. This differs from the finding of
Busby and Scott Cato mainly because different areas were employed by CERRIE and a
slightly different period was employed. Combining the UK increases with those in Greece
and Germany, (where the doses were greater) gave a 43% increase in infant leukaemia in
the combined cohort of 2.2 million births in children exposed to a mean population
weighted dose of 0.067 mSv. This dose is calculated from data supplied by NRPB to
CERRIE and also based on UN data from Savchenko 1991 and also data from Kaletsch et
al.1997. The mean dose was obtained by population weighting the foetal doses determined
for each country supplied by NRPB to the CERRIE committee for UK and obtained from
the German study where the doses were measured by the German Radiological Protection
personnel and from UN data for Greece. I should emphasize that the internal dose here is
unknown. The dose calculations are based mainly upon external dose, mainly gamma shine
from Caesium-137 deposition. However, it is just this (mainly) external dose that is
employed in radiological modelling of health effects and so, for the purpose of what
follows, this is the dose that is relevant.
In calculating the dissonance between the predictions of the ICRP models and the
observed number of cases found in Scotland and Wales, Busby and Scott Cato 2000 used
the ICRP foetal risk factor of 0.0125 per Sievert (employed by COMARE 1996 to examine
the Sellafield child leukemias). However, in discussions within CERRIE, it was pointed out
that the obstetric data of Stewart et al (1956) was a firmer basis on which to base any
analysis of the risks from internal exposure. Stewart et al found a 40% increase in
childhood cancer aged 0-14 after an X-ray dose of 10mSv (Wakeford and Little 2003).
Although this has been disputed by some as being causal this value has been translated by
Wakeford and Little into a relative risk of 50 per Sievert. It is this value that both Richard
Wakeford of British Nuclear Fuels Ltd and Colin Muirhead of NRPB used to analyse the
infant leukemias for the CERRIE report (CERRIE 2004a).
If I take it that a 10mSv X-ray dose causes a 40% increase in childhood cancer, we
can see from Table 6 that a mean dose of 0.067 mSv from Chernobyl fallout has caused an
increase in infant leukemia of 43%. The corresponding error in the application of the
obstetric external risk factor to the infant leukemias is thus 43/40 * 10/ 0.067 = 160. There
were therefore 160 times more infant leukemias in this combined population than would be
predicted by the use of the obstetric X-ray data. And this is only in children aged 0-1. This
is a minimum value, as we have yet to see what other cancers or leukemias emerge in this
group as they age between 1 and 14 years. I am in the process of obtaining data from
Scotland and Wales to enable me to carry out such an analysis.
Dose response relationship.
Because the database is so large, we can safely conclude that there was an increase in infant
leukaemia in the high and intermediate exposure areas in those children who were exposed
in utero to the fallout from Chernobyl. We cannot say that the effect was not due, in part, to
parental pre-conception irradiation, since our exposed groups were born up to the end of
1987.
In addition to the discovery of a clear effect, there was also a biological gradient in
the rates over a certain range. Fig 1 shows the increases in infant leukaemia in the European
countries with dose. In Germany, Kaletsch et al 1997 had data for three dose areas and
found that the dose response was biphasic. This is also true for the data from the UK when
it is subdivided into the high, intermediate and low dose areas. In both countries the highest
effect was in the intermediate dose area. Infant leukaemia increases were also reported in
Belarus (Ivanov et al,) and the effect there was quite modest although the doses were higher
139
ECRR 2006: CHERNOBYL 20 YEARS AFTER
than in Greece. The data suggest that over the range 0-2mSv the overall dose response is
biphasic.
Fig 1 Dose response for infant leukaemia in the countries examined by this study and
CERRIE. (Data from CCRG and CERRIE 2004a.) Effect is fractional excess risk, and dose
is in mSv.
This biphasic behaviour is not so remarkable for an in utero cause and endpoints in the
living child since above a certain dose some defence system may become overwhelmed and
foetal death may intervene. However, it is uncertain that the dose levels reported correlate
with internal exposures of the specific type that cause the illnesses. In the main, the
exposures used for these studies are based upon external radiation measurements or ground
deposition of Caesium. If the exposures were to milk from cattle fed winter silage
contaminated with radionuclides, this milk might end up anywhere in the area, not
necessarily where the main deposition was; indeed dairy cattle are unlikely to be feeding in
such areas where the rainfall is high e.g. mountains.
The results found here show that there was an increase in infant leukaemia in the
high and intermediate exposure categories chosen by CERRIE in the UK. The magnitude of
the effect was lower than that found by Busby and Scott Cato whose diagnosis period study
found RR = 3.87 p = 0.0001 for the combined Scotland and Wales exposed cohort, roughly
in line with an earlier report by Gibson et al. for Scotland. This may not be surprising since
the areas defined by the CERRIE analysis are quite different.
Given the extremely low mean doses involved in the combined exposure area, UK,
Greece and Germany (< 70μSv), the increase in infant leukaemia was not predicted by the
ICRP model and defines an error in the use even of the risk factor defined by the obstetric
X-ray data of at least 160-fold.
The CERRIE committee analysis of the data found a similar mismatch between
the expected number of cases in the UK, Germany and Greece but failed to draw any
sensible conclusion. Table 4A6 from CERRIE 2004 is reproduced below as Table 7. The
low value for Belarus may result from a biphasic dose response, but at least part of the
explanation is the falsification of leukaemia records by the Soviet State who were
concerned to minimise the evidence of the effects of the Chernobyl catastrophe (Busby and
Yablokov 2006). Despite the clear dissonance between what was calculated by the
representative of British Nuclear Fuels Richard Wakeford and the chief epidemiologist of
NRPB, Colin Muirhead, who prepared table 4A6, the text of the CERRIE report (p88) is
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
at odds with the table, stating clearly: any suggestion that the risk of infant leukaemia
arising from exposure to radionuclides in Chernobyl fallout has been materially
underestimated is largely based on the findings of just one study.
In the body of the majority CERRIE report the rapporteurs conclude:
Overal,l the findings . . . do not provide sufficiently persuasive evidence that the
risk of internal exposure to radionuclides is seriously underestimated by risk estimates
obtained by studies of exposure in utero to sources on internal irradiation. In the
judgement of the large majority of the Committee members, it is likely that radioactive
fallout from the Chernobyl accident resulted in an increased risk of infant leukaemia. A
substantial fraction of members think that this increase is at the level anticipated by current
risk models.
It is hard to see how these statements can be rationalised with the results
presented in the table 4A6 in the same report. The International Cancer Agency in Lyon
(IARC) had been expected to produce a report on infant leukaemia and wrote to CERRIE in
2004 to say that they were finishing off a study, but an enquiry at the time of writing
resulted in no new news on this IARC investigation.
Table 7 Table 4A6 from CERRIE 2004a; Excess relative risk of infant leukaemia estimated
in four birth cohorts.
Study
ERR (95% CI)
ERR coefficient Sv-1
(95% CI)
Great Britain
0.22
(-0.14, 0.69)
1.6
(0.4, 4.1)
0.48
(0.02, 1.15)
0.26
(-0.24, 1.10)
11000
(-7000, 34500)
8000
(2000, 20500)
4800
(200, 11500)
130
(-120, 550)
Greece
Germany
Belarus
ICRP ERROR
Ratio to external
ERR coefficient
(95% CI)
220
(-140, 690)
160
(40, 410)
96
(4, 230)
2.6
(-2.4, 11)
Conclusion
The ICRP model has been criticised for lack of scientific method (ECRR2003). In
particular, the ECRR argued that the use of acute external irradiation data to inform the
model for health risks from internal chronic irradiation involved misuse of scientific
method and employed deductive rather than inductive reasoning. More recently, the French
nuclear risk agency IRSN has made largely the same points and has agreed that the ECRR
criticisms are valid (IRSN 2006). If these concerns are valid, then clearly it is not possible
to employ risk factors culled from the Japanese A-Bomb series to inform risk about internal
irradiation. And, by the same argument, it is not valid to employ the risk factors obtained
from the obstetric X-ray data. It is necessary to employ studies of children exposed to
internal chronic radiation from fission product isotopes if we wish to develop models to
predict or explain these same exposures. The nuclear site child leukemia clusters, e.g.
Sellafield, Dounreay and La Hague, and others reviewed by ECRR2003 have been
extensively studied and confirmed as being real and not due to chance. The denials of
causality (e.g. COMARE 1996) have been based upon the external irradiation risk models.
The difference between the yield of childhood leukaemia predicted by the ICRP or by the
obstetric data and the observed numbers for these nuclear sites is in excess of 300-fold. The
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
existence of infant leukaemia in these European cohorts shows that this denial is based
upon an invalid model. It seems clear that this model is completely falsified by the
existence of the infant leukemias in these European cohorts, clear and objective effects
described by different groups in different countries. These increases in infant leukaemia
have resulted from doses lower than those experienced by the nuclear site children who
developed leukaemia. In the case of the Chernobyl infant leukemias there is no alternative
explanation apart from internal radiation exposure to largely the same isotopes as the
nuclear site leukaemias. The significance for this result for radiation protection is
overwhelming.
References
Busby C and Scott Cato M (2001) ‘Increases in leukemia in infants in Wales and Scotland
following Chernobyl: Evidence for errors in statutory risk estimates and doseresponse assumptions’. International Journal of Radiation Medicine 3 (1-2) 23
Gibson BE, Eden OB, Barratt A et al. (1988) 'Leukemia in young children in Scotland'
Lancet 630
Busby C and Scott Cato M, (2000) 'Increases in leukemia in infants in Wales and Scotland
following Chernobyl' Energy and Environment 11 (2) 127-137
CERRIE Minority Report (2004b) Minority Report of the Committee Examining Radiation
Risk from Internal Emitters. (Aberystwyth: Sosiumi Press)
CERRIE Report (2004a) Report of the Committee Examining Radiation Risks from
Internal Emitters.' (Chilton :NRPB)
COMARE, (1996) The Incidence of Cancer and Leukaemia in Young People in the
Vicinity of the Sellafield Site in West Cumbria: Further Studies and Update since
the Report of the Black Advisory Group in 1984, COMARE 4th Report
(Wetherby: Department of Health).
ECRR (2003) 2003 Recommendations of the European Committee on Radiation Risk;
Health Effects of Ionising Radiation Exposure at Low Doses for Radiation
Protection Purposes Regulators' Edition: Brussels, 2003 Aberystwyth: Green
Audit
G. Etherington and M. D. Dorrian (1991), `Radiocaesium levels, intakes, and consequent
doses in a group of adults living in Southern England'. International Atomic
Energy Agency Document IAEA-SM-306/29 (Vienna: IAEA).
IRSN (2005) Les consequences sanitaires des contaminations internes chroniques par les
radionucleides. Avis sur le rapport CERI ‘Etudes des effets sanitaires de
l’exposition aux faibles doses de radiations ionisantes a des fins de
radioprotection’.DRPH 22005/20 Institut de Radioprotection at de Surete
Nucliare. Fontenay aux Roses: IRSN
Ivanov E, Tolochko GV, Shuvaeva LP, et al (1998) Infant leuiemia in Belarus after the
Chernobyl accident Eadiat. Env. Biophys. 37 53-5
Kaletsch U, Michaelis J, Burkart W and Grosche B, (1997) ‘Infant leukaemia after the
Chernobyl Accident’ Nature 387, 246.
Petridou E, Trichopoulos N, Dessypris N et al.. (1996) 'Infant leukaemia after in utero
exposure to radiation from Chernobyl' BMJ 314, 1200
Savchenko V K, (1995) The Ecology of the Chernobyl Catastrophe: Scientific Outlines of
an International Programme of Collaborative Research (Paris: UNESCO).
Stewart A M, Webb J W, Giles B D, Hewitt D, (1956), ‘Malignant Disease in Childhood
and Diagnostic Irradiation in Utero’, Lancet, ii 447.
Wakeford R and Little MP (2003) Risk coefficients for childhood cancer after intrauterine
irradiadiation. A review. Int. J.Radiat.Biol 79 293-30
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
CHAPTER 9
Liquidators Health: a Meta-Analysis
Alexey .V. Yablokov.
Councilor, Russian Academy of Sciences, Moscow.
This review is devoted to the analysis of data concerning the state of health of the
participants in the emergency work (“liquidators”) following the consequences of the
catastrophe in 1986 at the Chernobyl Power Station. Over a period of time, hundreds of
thousands of people took part in operations connected with the building of the sarcophagus
and in other measures aimed at limiting the consequences of the explosion in the 4th block
of the Chernobyl Power Station. The number of liquidators who took part in these
operations was approximately 740,000 people between 1986 -1990 (250,000 from Russia,
~360,000 from Ukraine, 130,000 from Belarus).
Undoubtedly, the majority of these people were exposed to additional external and
internal radiation. This fact would have adversely affected the state of their health.
However, in recent years, specialists connected with nuclear industry have claimed that the
health of this group of people, on average, does not differ from that of other population
groups in Russia, in Ukraine and in Belarus, and, they claim, sometimes it is actually better.
This fact was keenly described in the report of the group of specialists from the “UN
Chernobyl forum” “Health Effects of the Chernobyl Accident and Special Health Care
Programmes”, presented under the aegis of IAEA and of WHO.
1. Introductory remarks
While analyzing data regarding the liquidators’ health it is necessary to have in view the
nature of the initial data. It is well known that, during first years after the catastrophe,
doctors were officially prohibited from connecting diseases of the affected population with
the radiation. This is why all data concerning the sickness rate within the territories polluted
by the Chernobyl radioactive fall-out collected up to 1989 must be considered as false “probably counterfeited”. An obvious example may be taken from the official data referring
to the number of cases of leukemia. It is well known that leukemia is the first oncological
consequence of radiation. The Russian national register data referring to cases of leukemia
among the liquidators, for the first 8 years after the catastrophe, are presented in table 1.
Beginning in 1990, the essential increase in the number of registered cases of
leukemia is usually treated as corresponding to peaks of leucosis in the cohort of those
irradiated in Hiroshima and in Nagasaki (Tsib, Ivanov, 2000). It is interesting to note that
the Japanese and Chernobyl data regarding the increase in leukemia correspond well to the
relaxation of the regimes of secrecy.
.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 1 Officially registered leukemia cases for liquidators by date of diagnosis, 1986-1993
(Ivanov et al., 2004, Table 6.6)
Date of diagnosis
1986
1987
1988
1989
1990
1991
1992
1993
Number of cases
1
5
5
3
6
11
9
8
It is well known that the occupying authorities prohibited any research into the
consequences of radiation in Japan. That is why the official register only begins in 1950 –
four and a half years after the nuclear bombing. In the USSR the prohibition on the
diagnosis of radiation-induced diseases was also canceled after 4 years. Therefore, we can
assume that the cases of leukemia recorded between 1986-1989 are only a small number of
the actual cases of this disease. Officially, “full dosimetric control” of the participants in the
work within the zone of the Chernobyl power station took place over only several months
(Gerasimova et al., 2001, p. 11). This happened for a number of reasons, some of which are
listed below:
• Secrecy;
• Absence of suitable equipment;
• Carelessness of staff and of liquidators;
• Low qualification of staff;
• Deliberate distortion of notes.
An essential distortion of the statistics concerning the illnesses of the liquidators may
originally have been connected with the fact that the status of ‘liquidator’ is not conferred
automatically, but only following individual applications. The result is that, today, the
status of ‘liquidator’ refers not only to the persons who were immediately exposed to
increased radiation, but essentially to all of the persons who were within the zone of
radiation danger in the early period. The official status of ‘liquidator’ incurs the receipt of a
wide spectrum of state benefits (increased pension, habitation, transport, drugs, medical
care and others). The conferring of this status is appointed only after numerous formal
terms and conditions, the successful execution of which is connected with, not only the
presence of objective indexes of worsening of health, but also with a number of subjective
factors. Until recent years, the true liquidators, for various reasons, didn’t officially register
their status as ‘liquidator’. Some did not register because of social-psychological reasons
(for example: “I am strong, I don’t want to go begging”); others for technical (bureaucratic)
reasons. Also, it is well known that a number of military personnel who took part in the
Chernobyl operations have no official documents confirming their participation in the
liquidation work. At the same time, it is well known that among persons who hold this
status there are many who obtained it without the correct, objective indexes.
All these factors make it impossible to hold an objective analysis of the statistics
relating to the illnesses of the liquidators. Occasionally, these factors deprive the research
of any scientific (epidemiological, radiobiological) sense.
On the whole, for an objective evaluation of the connections between the level of
illness and the level of additional received radiation, it is clear that the liquidators of 1986-
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
1987 recieved large doses. With the development of methods for individual biological
dosimetry (the determining of additional doses of received radiation by measuring the
structure of chromosomes (FISH method) and the calcinated tissue within the tooth (ESR
dosimetry)) we have an opportunity to reconstruct and achieve verification of received
doses of radiation. The comparison of data gained by these methods show that officially
documented doses of radiation may be either top-heavy or understated (Maznik and
Vinnykov, 2003).
In spite of the volume of work involved in compiling state registers of the liquidators in
Russia, in Ukraine and in Belarus, these data cannot be considered reliable. The official
medical authorities acknowledge that the number of Russian liquidators who received doses
over 25*10-2 Gy may be 7 times higher (!) than is shown in the registers (Il’in et al., 1995).
2. General morbidity
Among the people who were sent to Chernobyl, there was no illness– everyone was
healthy, and, in general, young. Within five years of the catastrophe, 30% of them were
already officially considered sick; within ten years less than 9% of liquidators were
considered healthy and within 16 years only about 1-2% left among them were considered
to be healthy (Table 2).
Table 2 Dynamics of the liquidator’s health condition
(Ivanov et al., 2004; Preebylova et al., 2004)
Year, after catastrophe
1986
0
1991
5
1996
10
2002
16
“Sick” persons, %
0
30
90 – 92
98 – 99
In Ukraine, 18 years after the catastrophe, the number of sick among the liquidators
reached 94,2% (in Kiev – 99,85%, in Sumskaya province – 96.53%, in Donetskaya
province – 95,95%) (Chernobyl… 2004).
General morbidity in Ukrainian liquidators increased by 3.5 times over 10 years
(Serduk, Bobyleva, 1998). 15 years after the catastrophe this figure increased by three times
among Russian liquidators under the age of 30. The annual rates of growth of morbidity
among Belarusian liquidators are 2-8 times higher than the control group from the
population of Belarus (Antypova et. al., 1997).
As the data in the Russian national register show, the main cause of morbidity among
the liquidators in 1996 was diseases of the respiratory organs; of the nervous system; of the
sensory organs; of the circulatory system; of musculoskeletal system; of connective tissue
and of the endocrine system. In previous years the dynamics for morbidity were different
(in 1993; diseases of respiratory apparatus – 15,5 %; of the musculoskeletal system –
14,5%; of digestive system – 14,0%; in 1995; diseases of digestive apparatus – 15,9 %, of
the musculoskeletal system and of connective tissue – 14,8 %; of the nervous system –
14,0 %; Problems …, 2002).
Morbidity differs among different age groups of Russian liquidators: in the group of 2549 year olds mental illnesses and diseases of the nervous system are higher; in the group of
30-59 year olds diseases of the musculoskeletal system, of the endocrine system and of the
metabolism are more frequent (Problems …, 2002).
For a number of diseases, the morbidity of the liquidators is notably higher than the
morbidity of the population of Russia and Belarus (Table 3, Table 4)
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Table 3 Russian liquidators’ incidence rate (male, 1996, per 100 000)
(data from RNMDR by V. Ivanov et al., 2004)
Disease
Respiratory system
Nervous system and sensory organs
Digestive system
Cardiovascular systems
Musculosceletal system and connective
tissue
Endocrine and metabolic
Mental disorders
Urogenital system
RNMDR
14 215
11 041
8 613
7 117
7 012
Russia
15 073
5 299
2 602
1 700
3 054
Ratio
0,9
2,1
3,3
4.2
2,3
4 637
2 889
2 383
454
586
3 519
10,2
4,9
0,7
1 552
3 875
0,4
Infection and parasitic
782
3 053
0,3
Neoplasms
713
882
0,8
Blood and blood-forming organs
304
135
2,3
Skin and subcutaneous tissue
Total
61 687
41 748
1,5
Table 4.Belarus liquidators incidence rate (1995, cases per 100,000 persons)
(Matsko, 1999)
Disease
Liquidators
Belarus population
(older than 18)
Thyroid cancer
23.1
7.1
Cataracts
462.8
156.1
Malignant neoplasms (lymphatic and
blood-forming organs)
26.1
18.6
Respiration organs diseases
24 781
23 831
Digestion organs diseases
7 784
1 651
Endocrine system diseases, nutritional
disorders, metabolism and immunity
disorders
Blood and blood-forming tissue
diseases
Mental disorders
3427
518
304.4
69.4
3252
1090
According to some data (Gylmanov et al., 2001), general reasons for invalidity of the
liquidators are diseases of the cardiovascular system (47,2 %); of the nervous system (19,8
%); diseases of the digestive system (15,4 %) and neoplasm (8,8 %). According to other
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
data (Gerasymova et al., 2001; Problems… 2002) – they are diseases of the nervous system
(28,4 %), of the circulatory system (24,0 %) and mental disorders (15,7 %).
Even the data from the national official register (obviously understated) show that the
morbidity of Russian liquidators, in a series of indexes, has risen stably over recent years
(Table 5).
.
Table 5 Dynamics of newly detected cases of the Russian male liquidators’ diseases (per
100 000) in 1997 – 2001 by RNMDR (after Ivanov et al., 2004)
Diseases
Neoplasms
Blood and blood-forming organs
Infections and parasitic
Cardiovascular
1997
1,17
0,36
1,14
12,04
1999
1,47
0,43
1,40
14,54
2001
1,84
0,56
1,52
15,52
% increasing
158
156
133
129
In a wide investigation (3,882 person) the dynamics of general morbidity among
liquidators over the 15 years following the catastrophe was observed (Karamalluin et al.,
2004). General morbidity among liquidators under 30 years of age at the time of the
catastrophe increased by 3 times over 15 years; in the age group of 31-40 year olds,
maximum initial morbidity fell in the 8-9 years after the catastrophe.
Among Ukrainian liquidators general sickness increased by 3,5 times during the first
ten years (Serduk, Bobyleva, 1998). A noticeable increase in somatic pathology and in
oncological diseases (more expressed than in the general population) was observed among
Ukrainian liquidators (Golubchykov et al., 2002).
A growing rate was observed also for a number of different illnesses per person
(polymorbidity) : before 1991 - 2,8 diseases per person, in 1995 - 3.5, in 1999 – 5,0
(Lyubtchenko and Agal’tzev, 2001).
Common causes of invalidity in the Russian liquidators are diseases of the
cardiovascular system (47,2 %), of the nervous system (19,8 %), diseases of the digestive
apparatus (15,4 %) and neoplasms (8,8 %), which arrange 91,2% from all causes of
invalidity (Gylmanov et al., 2001). Within the list of all diseases, priority belongs to
digestive organs pathology, the system of blood circulation, neurological system and
sensory organs. These three diseases classes compose 85 - 87 % of all causes of
invalidisation in Ukranian liquidators (Bebeshko and Kovalenko, 19994 Prysyazhnyuk et
al., 2002). Several years after catastrophe the process of invalidisation became more visible
(Table 6).
Table 6 Dynamics of invalidization (per 1,000) among liquidators by dosage groups, 19901993
(based on RSMDR, from Ryabzev, 2002)
Year
1990
1991
1992
1993
147
0-5 cGy
6,0
12,5
28,6
43,5
5-20 cGy
10,3
21,4
50,1
74,0
More than 20 cGy
17,3
31,1
57,6
84,7
ECRR 2006: CHERNOBYL 20 YEARS AFTER
There are some data relating to a decrease in sexual potency among half of examined
male liquidators (Dubivko, Karatay, 2001) and the violation of spermatogenesis among
male liquidators (Oganesyan et al., 2002).
3. Mortality
There are 4,136 registered cases of death in the cohort of 52,714 liquidators between 19911998, according to official data of the Russian State Register (Ivanov et al., 2002), and
during the 15 years following the catastrophe more than 10,000 liquidators died
(Gerasymova et al., 2001). The standardized mortality ratio (SMR) varies from 0.78 to 0.88
among this cohort for 4 groups of causes of death:
• from all causes;
• from malignant neoplasms;
• from all causes, except malignant neoplasms;
• from trauma and from poisoning;
Statically this does not differ from the control group of the population. Data regarding the
employees of the Kurchatovs Institute show similar results to that of the liquidators
(Shikalov at al., 2002). A significant increase in cancer deaths among 66,000 Russian
liquidators (the mean calculated dose about 100 mSv) is officially reported for the
observation period 1991 – 1998 (Maksioutov, 2002). The ERR coefficient is estimated to
be 2.04 Sv-1 (95% CI: 0.45 - 4.31).
These data essentially differ from the others. According to data of A.A. Gilmanov
et al., (2001) the mortality among male liquidators is higher by 1,4 - 2,3 times than in
corresponding age groups within the population. The calculations made by the author of
this review showed that the average age of 162 liquidators who died during last 10 years in
the town of Tollyaty (Samarskaya province, Russia) was about 46.2 years old (Tymonin,
2005). The average lifespan for 169 liguidators from nuclear industry institutes who died
between 1986 – 1990 was 45.5 years (Tukov et al., 2000). In the Kaluga province National register data, - the average age of death for 84.7 % of liquidators was only 30 39 years old (Lushnykov and Lantzov, 1999).
According to the register of liquidators from enterprises in the nuclear field
(14,827 men and 2,825 women were examined) the increased level of mortality was among
persons with diseases of the circulatory system; of vegeto-vascular and of neuro-circulatory
dystonia (Tukov et al., 2002). According to other data (Gylmanov et al., 2001); diseases of
the circulatory system (50.9 %); traumas (26.3 %); neoplasms (5.3 %) and diseases of the
digestive organs (5.3 %) were the most recent causes of mortality among male liquidators.
In 1993 the main causes of mortality for the whole cohort were (Problems… 2002);
traumas and poisonings (46 %); diseases of the circulation organs system (29 %) and
malignant neoplasms (13 %).
Relative risk of untimely death for this group of liquidators was compiled as
follows (Ignatov et al., 2004);
• from malignant neoplasms – 16.3%
• from diseases of the system of hematosis – 25.9%
• from traumas and poisonings – 39,6%
• from other causes– 18,2%
From the Official Russian Inter-agency Expert Council the percentage of mortality among
Russain liquidators in the year 2000 was (Khrysanfov and Meskich, 2001);
• 63 % - circulatory pathologies;
• 31% - malignant neoplasms;
• 7% - digestive tract pathologies;
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•
•
•
5% - lung pathology;
5% - traumas and poisoning;
3% - tuberculosis.
4. Premature aging
Processes of premature aging are typical for the liquidators. Many liquidators’ diseases
develop 10-15 years earlier than the average within the population. Among the features of
this premature aging are (Javoronkova et al., 2002; Holodova and Zubovsky, 2002;
Vartanyan et al., Krasylenko, Eler Ayad, 2002);
• A breach of supreme physical functions;
• An accumulation of diseases typically found in the elderly but inconsistent
with the age of the liquidator (10,6 of diagnosis for one liquidator, 2.4 times
higher than in control group);
• Degenerative-dystrophic changes in different organs and tissues;
• Accelerated ageing of the brain vessels;
• An imbalance in the antioxidant system.
This research, which lasted 10 years, of a group of 942 invalid liquidators (age 50-70 years
old) showed that, in 42 % of cases, cerebral vascular diseases were the main cause of
invalidity; in 30 % of cases it was diseases of the cardio vascular system and hypertension.
All liquidators had attendant illnesses such as degenerative diseases of the support-motor
apparatus, diseases of the alimentary canal and type 2 pancreatic diabetes. These are typical
ailments that signify premature ageing (Zubovsky and Malova, 2002).
5. Cancers
By this time, the Russian National Register had accumulated evidence concerning an
increase in frequency of some malignant neoplasms among liquidators who worked
between 1986-1987 (Ivanov and Tsyb, 2002). By 1996, according to this data, 52 cases of
leukemia were found among the liquidators, 47 cases of thyroid cancer and 1,786 cases of
other types of cancers. The frequency of leucosis and thyroid cancer was higher than the
spontaneous level for corresponding age groups within the population (Ivanov et al., 2001).
All these liquidators’ cancer cases, as officially described (Ivanov et al., 2004),
agree, within the 95% confidence interval, with rates for the general Russian population. It
is noted, by the way, that the estimations of radiation risk are preliminary because the
follow-up period is rather short (Ivanov et al., 2004, p. 180).
At the same time, a detailed analysis of concrete groups arrives at quite different
conclusions. For instance; the incidence of some malignant neoplasms in female liquidators
differs statistically and is higher than the incidence in corresponding age groups within the
female population of Russia (Islamova, 2004); the standardized illness relation (SIR) for
cancers in all locations is 1.34 (CI 1.17-1.79); for thyroid cancer SIR is 7.85 (CI 3.23-8.77);
for cancer of the mammary gland SIR is 1.84 (CI 1.23-2.45).
The most reliable cancer data available for Belarusian liquidators is presented in
Table 7.
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Table 7 Incidence of cancers among Belarusian male liquidators, 1993 – 2000, per 100 000
(Okeanov et al., 2004)
Site
Liquidators
All sites*
400,8 ±7,7
Colon*
21,6±1,8
Urinary bladder*
16,9±1,6
Rectum
19,1±1,7
Lung
56,9±2,9
Breast
59,8 ±6,7
Kidney
16,2±1,6
*Significant differences.
Control group
361,2±6,4
16,1±0,6
10,4±0,4
17,9±0,6
53,9 ±1,6
57,3 ±0,9
13,0±0,9
The incidence rate for leukemia among Ukrainian liquidators is presented in Table 8.
Table 8 Incidence rate for leukemia among Ukrainian liquidators
(Imanaka, 2002)
Year
1987
1988
1989
1990
1991
1992
Total
Incidence rate (per 100 000)
Liquidators-1986 Liquidators-1987
13,33± 4,71
6,42 ± 3,21
6,32 ± 4,47
14,06 ± 4,69
4,41 ±3,12
14,50 ± 4,59
5,32 ± 3,07
18,13 ± 4,84
7,74 ± 3,46
12,59 ± 3,98
12,02 ± 4,25
13,35 ± 1,80
7,04 ±1,57
The most significant increases in thyroid cancer occurred between 1990-1993 and 19941997, among Ukrainian liquidators working in 1986-1987. For liquidators working between
1986-1987, the leukemia and lymphoma incidence rate was significantly elevated between
the years 1990-1993 and 1994- 1997. In 1989-1991 there was an observed high risk of
leukemia for the liquidators of 1986 in comparison with liquidators of 1987. Russian
liquidators from the same period displayed an increase in all types of leukemia, including
chronic lymphoid leukemia and chronic myeloid leukemia. In Belorusian liquidators who
were exposed between 1986 - 1987 an increase in acute leukemia was seen for 1990 – 1991
(Ledoshchuk and Gudzenko, 2001; Ivanov et al., 1997; Pryayazhnyuk et al., 2002). A
statistically significant increase in breast cancer incidence rate in the period 1994-1997 was
also observed in female liquidators exposed in 1986-1987 (Pryayazhnyuk et al., 2002).
6. Diseases of the nervous system, sensory organs and psychiatric illnesses.
The level of morbidity from diseases of the nervous system and of the sensory organs
among Ukrainian liquidators increased above the average level in the country by 3 times in
1996 (Serduk and Bobyleva, 1998), and among Russian liquidators by 6,4 times in 1995
(About ecological… 2002).
Among liquidators, the number of persons with memory impairments - such as a
reduction in the ability to memorize words and images- is unusually high. Such impairment
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
is connected with organic changes within the structure of the frontal lobes of the brain. 80
male liquidators who were examined in 1986 suffering from encephalopathy were found to
have a structural / functional inferiority of the frontal lobes of the brain and of the left
temporal region, including the cortico-subcortical connections (Antypchuk, 2002, 2003).
Among 150 male liquidators (44.5 ± 3 years old) studied, evidence was found of slow
forms of the activity and the decreasing of the inter-hemispheric asymmetry {sic}, a
decrease in the quality of execution of all cognitive tests, a deterioration in memory and
other superior psychological functions (Javoronkova et al., 2002). The average age of the
liquidators (male and female) with encephalopathy is 41.2 ± 0.83 years old (Stepanenko,
2003); that is considerably lower than for the population in general.
The clinical and electro-neuro-myographical data show that, among liquidators, the
impairment of the peripheral nervous system develops as a result of vegetal-sensing
polyneuropathy, which differs from other kinds of poly-neuropathy (Sokolova, 2000).
Research on psychosomatic disturbances among 400 liquidators (24 – 59 years old)
shows that they have a marked reduction in functional activity of the CNS, which is
conditioned by irreversible damage to the structures of the brain (Antonov et al., 2003,
Tsygan et al., 2003).
There is no doubt that psychical disorders are widespread among the liquidators (Nyagu
and Loganovsky, 1998; Rumyantseva et al., 2002 and other). 10 years after the catastrophe
psychical disorders among Russian liquidators were encountered 4,3 -5 times more
frequently than in corresponding groups of the population. A high level of psychiatric
disorders among Ukrainian liquidators was observed, especially in 1990-1993 (Nyagu et
al., 1999).
Pathological changes in the structure of the brain include atrophy and widening of the
ventricles and focal changes (Loganovsky et al., 2003; Nyagu and Loganovsky, 1998).
Among the liquidators, indices of neuro-psychic disorders are several times higher then
among other population groups within the NPP zone (Nyagu et al., 2002).
Up to 45,9 % of the liquidators have hearing disorders (Zabolotny et al., 2001).
Incidence rates for cataracts among Belarusian liquidators are more than twice as high as
the general population (Table 9).
Table 9 Incidence rate (per 100 000) of cataracts in Belarus, 1993-1994 (Goncharova,
2000)
Liquidators
1993
1994
281,4
420,0
Belarus
population
136,2
146,1
7. Respiratory system
Over time, the incidence of chronic broncho-pulmonary diseases among liquidators
increased (Jakushin and Smirnova, 2002; Tseloval’nykova et al., 2003); especially noted
are disorders associated with the regulation of breathing caused by a functional decrease in
lung capacity and a decrease in elasticity due to impairment of the interstitial structures of
the blood-air barrier and the development of peri-alveolar radiation fibrosis (Kuznetsova,
2004). It has been shown that the majority of liquidators that were exposed in 1986-1987 to
the inhalation influence of radioactive nuclides have developed progressive breathing
disorders (Chykina et al., 2002).
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8. Cardiovascular system
The level of morbidity among liquidators with vegetative vascular dystonia, 10 years after
the catastrophe, exceeded the average level for Ukraine by 16 times (Serduk and Bobyleva,
1998). 13 years after the catastrophe the level of cardiovascular diseases among Russian
liquidators was 4 times higher than in corresponding groups of the population (Bol’shov et
al., 2000). The frequency of development and the evidence of disorders of the
cardiovascular organs among the liquidators (especially among liquidators exposed in
1986-1987) are especially high compared with the general population. The results of one
typical investigation are presented in the table 10.
Table 10 Some characteristics of the cardiovascular system of male liquidators,
Voronejskaya province, Russia (Babkin et al., 2002)
Index
АD –
systole
АD –
diastole
CHD %
Stroke , %
The
average
thickness
of the
wall of
carotid
artery, mm
Burdened
heredity,
%
Liquidators
(n=56)
151,9 ± 1,8
Inhabitants of the polluted
territory (n=60)
129,6± 2,1
Control
(n=44)
126,3± 3,2
91,5± 1,5
83,2 ± 1,8
82,2±2,2
9,1
4,5
1,71± 0,90
46,4
16,1
0,81±0,20
33,3
0
0,82± 0,04
25
25
27,3
From the presented data we can see that the group of liquidators differs from all other
groups, which is especially significant bearing in mind that all groups share a similar
genetic background.
It was revealed that among 118 liquidators, studied over a period of 15 years, that
one third of them had developed ischemic heart disease (Noskov, 2004). In another study,
an increase (p<0,05) in the incidence of ischemic heart disease CHD, from 14,6% in 1993
up to 23,0% in 1996, was shown among controlled groups of liquidators (Strukov, 2003),
also noted was the syndrome hypodynamia of myocardium and a decrease in the arterial
vascular tone of the great circulation (Kovaleva et al., 2004) and an increase of systole
arterial pressure (Zabolotny et al., 2001). Among the liquidators of Kishinev (Republic of
Moldova) cardiovascular diseases, in recent years, have seen a 3-fold increase (twice that of
the control group); 25 % have infiltration of the aorta and 22 % have hypotrophy of the left
ventricle (Kirke, 2002). Various disorders of brain circulation have been discovered among
the majority of liquidators exposed between 1986-1987 (Romanova, 2001; Bazarov et al.,
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
2001). This tends to occur due to a change in the constructive characteristics of small
arteries and arterioles (Troshina, 2004). 10 years after the catastrophe, an examination of
410 liquidators who were exposed in April 1986 has shown that the dynamics of the indices
of chronic cerebral vascular pathology, of arterial hypotension, of CHD and of strokes is
higher than the indexes of the control group. It is crucial to note these changes among
young liquidators as they indicate an increased sensitivity to the factors involved in
radiation effects (Kuznetsova et al., 2004).
9. Musculoskeletal system
Pain in the bones and in joints is typical for the vast majority of the liquidators.
Approximately 50-57% of examined liquidators have manifestations of osteoporosis and
osteopathy. Radiation exposure in the younger age groups often leads to the development of
these diseases (Nikitina, 2002; Shkrobot et al., 2003; Kirke, 2002). 12 years after the
catastrophe, diffuse osteoporosis was discovered in the jaw structure of 88 % of examined
liquidators (Drujynina, 2004).
All liquidators examined at this phase have expressed disorders of vascular blood
circulation of the eyes, including crimps {sic}, aneurism and succises {sic}(Rud et al.,
2001). General conjunctive and vascular disorders were 10 times higher among liquidators
than in the control group (p<0,001).
Typically, these micro-circular disorders among liquidators are a result of damage
to the capillary endothelium – the interior lining of the capillaries (Petrova, 2003).
10. Skin
97% of liquidators with psoriasis have developed it after the catastrophe. In all cases,
psoriasis is accompanied by functional disorders of the nervous system and impairment of
the alimentary canal (Maljuk and Bogdantsova, 2001).
11. Blood and lymphatic System
Disorders connected with the blood and lymphatic system have been noted among the
liquidators. These differ considerably from the indices of the control group:
• The average duration of NMR-relaxation of T1 plazma of blood (Popova et al.,
2002);
• State of the erythrocytic membranes according to the index of activity of the
receptor-lectin reaction (Karpova and Koretskaya, 2003).
• An imbalance of the mean fractions of molecular components in platelets, in
erythrocytes and in blood plasma (Zagradskaya, 2002).
• A decrease in the dispersion of the granular multiplier {sic} in the lymphocyte
nuclei;
•
A decrease of the area of and of the perimeter distance of the ingranular zone and a
frequent increase in irregularity within this zone (Akulich, 2002);
• Change in the quantity of leukocytes, erythrocytes and lymphocytes in the peripheral
blood (Tukov et al., 2002).
Even after ten years, lymphopoiesis among liquidators remains disturbed (Table 11):
.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 11 The dynamics of the correlation of types (%) of lymphopoiesis among
Russian liquidators (by Karamullin et al., 2004)
Liquidators about 5 years after the
catastrophe
Liquidators 5-9 years after the
catastrophe
Liquidators 10-15 years after the
catastrophe
Healthy group (control)
Quasinormal
32
Types of the lymphopoiesis
HyperHyporeactivation
reproducer
55
13
38
0
62
60
17
23
76
12
12
12. Diseases of the digestive system and other internal organs
Diseases of the digestive system among Belarusian liquidators are registered 3,5 - 4 times
more frequently than among the adult population of the country (Antypova et al., 1997). A
controlled study of 118 liquidators, over 15 years revealed (Noskov, 2004):
• Changes in the liver - 40,6 % ;
• Changes in the structure of the pancreas - 60,2 %;
• Thickening of the gall-bladder wall – 29 %;
• Urolithiasis - 25 %;
• Changes in the thyroid gland - 60,2 %.
Structural changes of the pancreas increase with time (Table 12).
Table 12 Dynamics of change ( % of examined) within the pancreas among Ukranian
male-liquidators (Kamarenko et al., 2002; Komarenko and Polyakov, 2003)
1987-1991
1996-2001
Thickening of the gland
31
67
Increasing of the echogenicity of the tissue
54
81
Change of the structure
14
32
Change of the contour
7
26
Change of the capsule
6
14
Widening of the Wirsung’s duct
4
10
All changes of the echostructure
37,6
(1987)
87,4 (2002)
13-15 years after the catastrophe, liquidators, in comparison with control groups, have
(Pimenov, 2001; Drujynina, 2004);
• Intense development of caries;
• Pathologic dental abrasion;
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•
Diseases of the peridontium and of the mucous membrane within the mouth
In 1996, incidents of stomach ulcers among Ukrainian liquidators were 3,5 times higher
than the average for the Ukraine (Serduk and Bobyleva, 1998).
13. Disturbances of the hormone status
Morbidity of the endocrine system among Russian liquidators was 10 times higher in the 13
years after the catastrophe than in corresponding groups of the population (Bol’shov et al.,
2000). Deep reorganization of pituitary regulation and changes in hormone production by
the endocrine glands was revealed among liquidators (Drygina, 2002). 22 % of examined
male-liquidators have increased amounts of prolactin (the hormone of the pituitary), which
is typical only for young women (Strukov, 2003).
During 1990-1994 the risk of diseases of the thyroid gland was 8,9 times higher
among Belarusian liquidators than among the adult population of Belarus and by 1996
diseases of the thyroid gland among liquidators were 11, 9 times more common than among
the adult population of Belarus (Antypova et al., 1997). In a large group of Russian male
liquidators exposed in 1986-1987 (1,752 persons), an essential increase was revealed in the
number of cases of structural changes in the tissue of the thyroid gland 6-7 years after the
catastrophe (Table 13).
Table 13 Dynamics (number of cases in %) of structural changes of the tissue of the
thyroid gland of Ukrainian male liquidators (according Lyashko et al., 2000).
Feature
1992 г.
1994 г.
Nodal formation
13,5
19,7
Hyperplasia
3,5
10,6
Thyroiditis
0,1
1,9
Morbidity from chronic thyroiditis in Ukrainian liquidators between the mean for the
period 1992 -1995 to that in 2001 increased by 154 % (Moskalenko, 2003). The majority of
500 liquidators examined during the first years after the catastrophe had essential
disturbances to the pituitary suprarenal system. In 6 years there was a re- normalization of
the study indexes for the resting state, but this re-normalisation did not occur for condition
of functional load (Mitryaeva, 1996).
14. The growth in the number of genetic abnormalities – mutations
Numerous studies shortly after the catastrophe showed the presence of radiogenic
chromosome mutations in the lymphocytes of liquidators, a number of which was
correlated with a received dose of radiation (Shevchenko et al., 1995; Svirnovsky et al.,
1998; Begenar, 1999; Shykalov et al., 2002). During the first years after the catastrophe, the
number of unstable (dicentric and ring chromosomes) and also of stable aberrations of
chromosomes (translocation, insertion) essentially increased (Oganesyan et al., 2002;
Demyna et al., 2002; Maznik, 2003). Over time, rates of elimination of aberrations of the
chromosome type and of genome irregularities among liquidators who were exposed to
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
higher radiation decreased (Maznik and Vinnykov, 1997). 10-15 years after the catastrophe,
the level of stable aberrations in the lymphocytes of the peripheral blood of the liquidators
steadily increased (Mel’nikov et al., 1998; Pilinskaya, 1999; Pilinskaya et al., 2003).
Among liquidators exposed in 1986, the highest level of genetic damage was
observed in the builders of the sarcophagus and the dosimetrists (Table 14).
Table 14 Cytogenetic characters of the liquidators of 1986 within 3 months
(Shevchenko, Snegireva, 1999)
Persons, n
Cells scored,
n
Chromosome
aberrations, n
Dicentrics
+ centric rings
Chernobyl Nuclear
Power Plant staff
83
6015
23.7 ± 2.0*
5.8 ± 1.0*
Builders of the
“Sarcophagus”
Dosimetrists
Drivers
Physicians
Pripyat population
Control
* p< 0.05;
71
4937
32.4 ± 2.5*
4.4 ± 0.9*
23
60
37
35
19
1641
5300
2590
2593
3605
31.1 ± 4.3*
14.7 ± 1.7*
13.1 ± 2.3*
14.3 ± 2.4*
1.9 ± 0.7*
4.8 ± 1.7*
3.2 ± 0.8*
2.7 ± 1.0*
1.9 ± 0.8*
0--
Group
A cytogenetic study, which was performed 8 - 9 years after the catastrophe, shows that in
this group of liquidators the frequency of cells with translocations exceeds that of the
control group by nearly 4-fold (Shevchenko, Snegireva, 1999). The number of
chromosome aberrations expressed a clear peak in 1992 - 1993 (Table 15).
Table 15 Dynamics of cytogenetic characters (Mean ± SEM, 10-3) of lymphocytes in the
liquidators 1990 – 1995 (Shevchenko, Snegireva, 1999)
Persons, n
cells
scored, n
chromosome
aberrations, n
Dicentrics
+ centric rings
1990
23
4268
14.9 ± 1.9*
1.0 ± 0.5*
1991
110
20077
19.7 ± 1.0*
0.9 ± 0.2*
1992
136
32000
31.8 ± 1.0*
1.4 ± 0.2*
1993
75
18581
34.8 ± 1.4*
0.9 ± 0.2*
1994
60
181793
1.8 ± 1.3*
1.8 ± 0.3*
1995
41
12160
18.8 ± 1.2*
0.4 ± 0.2
Control
82
26849
10.5 ± 0.6
0.2 ± 0.1
* p< 0.05;
* Cdr - cells containing dicentrics and/or centric rings; ace - acentrics.
Cdr + ace*
5.3 ± 1.1
6.8 ± 0.6*
9.0 ± 0.5*
11.9 ± 0.8*
10.3 ± 0.8*
7.3 ± 0.8*
3.9 ± 0.4
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
15. Disturbances of the immune system
The immune system of the liquidators is in an unstable condition, resulting in a state of
immunodeficiency. Many liquidators, 10-15 years after the catastrophe, have a deviation in
the quantitative indexes of cellular and humeral immunity and changes in immune status
(Melnov et al., 2003; Matvienko et al., 1997; Shubnik, 2002; Gajeeva et al., 2001;
Novykova, 2003; Soloshenko, 2002; Korobko et al., 1996; Potapnev et al., 1998; Bazyka et
al., 2002; Maluk and Bogdantsova, 2001; Grebnyuk et al., 1999).
These changes appear in:
Changes in the correlation of the sub-population of T-lymphocytes,
T-helpers and T-supressors;
A general decrease in the amounts of T- and of B-lymphocytes;
A decrease in the level of serum immune globulin of A,G and M
classes;
Irregularities in cytokine production;
Activation of the neutrophilic granulocytes.
A frequency of morbidity due to allergic diseases such as rhinitis (increased by 6-17 times)
and hives (increased by 4-15 times) has occurred in liquidators from Obninsk city (Russia)
7-9 years after the catastrophe in comparison with the city population (Tataurstchykova et
al., 1996). 4 years after the catastrophe only 17 % of examined liquidators had restored
levels of neuropeptide dermophin, and more then 50 % had decreased levels of other
neuropeptides (of leu- and of methionine-enkephalin) (Sushkevich et al., 1995).
The majority of 400 examined Ukrainian liquidators have changes within the
ultrastructure of neurophils (destruction of the contents, hyper-segmentation of the nucleus,
anomalous polymorphous growths and others) and in the lymphocytes (increased sinuosity
in the contour of the membrane, a segregation of the chromatin and of structural
components with the nucleolus) (Zak et al., 1996).
17. Health of the liquidators’ children
There are more and more data concerning the abrupt decline in the health of the liquidators’
children. Ukrainian liquidators’ children have higher morbidity of the digestive organs, of
respiratory apparatus, of the nervous system and of the endocrine system. They are subject
to a number of congenital malformations, hereditary conditions and increased frequency of
infectious diseases (Ponomarenko et al., 2002).
In areas where detailed studies of the families of liquidators took place (for example in
Razanskaya province; Lyaginskaya et al.,2002), the following was shown:
• An increase in frequency of sick newborns;
• An increase in frequency of congenial malformations;
• An increase in frequency of births of children with a birth weight lower than 2,500
grammes.
• A delay in pre-natal development;
• A higher frequency of general sickness.
Such illnesses are more common among the children of liquidators exposed between 19861987 (Table 16).
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Table 16 The health of Russian liquidators’ children
(after Lyaginskaya et al., 2002)
Coefficient of the
prenatal development
delay
Morbidity
Congenital
malformation number
Unhealthy newborns
Father
received 5 and
more cSv
3
Father
received less 5
cSv
2
All children in
Ryazan’
procvince
1
Highest
Intermediate
Low
Highest
Intermediate
Low
Many newborn
Intermediate
A few
In studies of morbidity in liquidator’s children there is a prevalence of chronic disorders of
the ENT organs, deviations of red blood cells, fundamental abnormalities of the nervous
system, plural caries, chronic gingivitis and anomalies of the dental-jaw system (Marapova
and Hytrov, 2001).
It is also interesting that examined children have an increased number of
chromosome aberrations in the somatic cells. The number of deletions, of inversions of the
rings, of isochromatid and single fragments, of breaks and of cases of polyploidy has
increased (Ibragymova, 2003).
Even according to the evidently understated data from the Russian National Register,
among liquidators’ children, less than 30 % are listed in the group regarded as “healthy”
(Table 17).
Table 17 Health conditions of the liquidators’ children
(V. Ivanov et al. 2004)
Group
Liquidators (%)
Their children (%)
“Healthy”
8,6
27,8
“Need further examination”
24,0
54,4
“Sick”
67,4
17,7
18. Conclusion
This review is based on material that was published largely between 2000 - 2004 and
discusses data concerning the heath of liquidators 10-15 years after the catastrophe. The
total number of publications addressing this problem includes more than 1,500 articles and
other papers and to summarize this volume of research would require not an article but
several monographs. However, the data from this review is enough to form a conclusion:
The health of persons who took part in measures to minimize the consequences of the
Chernobyl accident, and who received additional doses radiation, is disastrous. Liquidators
die much earlier, fall ill more frequently and remain ill longer (with many diseases) than
people from corresponding age groups throughout Russia, Belarus and Ukraine.
158
ECRR 2006: CHERNOBYL 20 YEARS AFTER
This happens in spite of regular, additional and intensive medical care, including
drugs and sanatorium / spa treatments. Thanks to more careful medical examinations we
can definitely say that the consequences of radiation in small doses cannot be reduced to
“radio-phobia”, or to “victimization”, or to social-economic problems, as is widely claimed
by specialists connected with the nuclear industry.
Material concerning the health of liquidators shows that some structures of the
nervous system (including the central nervous system) are especially damaged by low-level
radiation. Different epithelial cells (including the lining of the capillaries) and the immune
system are also acutely vulnerable
Data relating to liquidators’ health show that the official falsification of medical data
between 1986-1989 exclude the possibility of an accurate estimation of the full
consequences of the Chernobyl catastrophe. For example the “UN Chernobyl Forum” states
that 50 liquidators have died because of acute radiation sickness, about 300 liquidators have
died from cancers and less than 5,000 additional Chernobyl-related cancer deaths are
predicted for the future. However, the data considered here show that these figures must be
increased by a level of 2-3 orders of magnitude (i.e. up from 100 to 1,000 times higher).
In pursuance of improving the efficiency of treatment for the liquidators it would be
expedient to obtain data from individual ESR (dosimetry of tooth enamel) and the FISH
(Fluorescence In Situ Hybridisation) method, in order to determine the damage to the DNA,
which would provide a better retrospective measure of dose than the official records, which
are clearly incorrect.
Literature
About the ecological factors of the worsening of the demographical situation. 2002.
«Ecological Security of Russia». Material of Interagency Commiss. On Ecolog.
Security, RF Security Council (September 1995 – April 2002), 4, Moscow, pp. 211225 (in Russian).
Akulich N.V. 2003. Epigenotype of the lymphocytes among persons exposed the ionizing
impact. Selected Sci. Papers, Mogilev’ State Univ. name A.A. Kuleshov, Mogilev,
pp.204 -207 (in Russian).
Alymov N.I., Pavlov A.Yu. Sedunov S.G., Gorshenin A.V., Popovich V.I., Loskutova
N.D., Belobrovkin E.A. 2004. The estimation of the condition of the immune
system of the organism of the persons living on the territory exposed to the radiation
impact because of the catastrophe on Chernobyl NPP. «Med.-biol. Problems of antiradiation and anti-chemical protection”. Collect. Of Papers Russian Sci. Confer.,
Sankt-Petersburg, May 20-21, 2004, Sankt-Peterburg, pp. 45 - 46. (in Russian).
Antypova S.I., Korjunov V.M, Polyakov S.M., Furmanova V.B. 1997. Problems of the
health state of the participants of the liquidation of the consequences of the
Chernobyl’s catastrophe. «Med.-biol. Effects and ways to overcome the
consequences of the Chernobyl accident», Collect. of Sci. Papers, devout. 10th
anniversary of Chernobyl’ accident. Minsk – Vitebsk, p. 3 (in Russian).
Antypova S.I., Korjunov V.M., Suvorova I.V. 1997a. The tendencies of liquidator’s
morbidity with chronic non-specific diseases. «Actual problems of the med.
rehabilitation of the suffers after Chernobyl’ catastrophe», Materials Sci.- Pract.
Conf., devout. By 10th anniversary of Republican Hospital of Radiation Medic.
(Minsk, 30 June, 1997), Minsk, pp. 59 – 60 (in Russian).
Antypchuk K.Yu. 2003. Memory state of the persons who have had the acute radiation
sickness because of the catastrophe of Chernobyl’s NPP in the remote period.
Ukrainian Radiol. Jour., vol. 11, № 1, pp. 68 -72 (in Ukrainian).
159
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Antonov M.M., Vasil’eva N.A., Dudarenko S.V., Rozanov M.Yu., Tsigan V.N. 2003.
Mechanisms of forming of psychosomatic irregulations under the influence of small
dozes of ionizing radiation. New Med. Thechnol. Herald, vol. 10, № 4, pp. 52 – 54
(in Russian).
Arynchina N. T., Milkamanovich V.K. 1992. The Comparison characteristic of the 24hour monitoring data of heart arrhythmias among invalids with the ischemic heart
disease living on the territories polluted by the radioactive nuclides and in clean
regions of Belarus. Abstracts, Jubille Conf. 125th Belarus Sci. Therapeutic Soc.,
Minsk, 22-23 December, 1992, Minsk, pp. 75 –76 (in Russian).
Babkin A.P., Choporov O.N., Kuralesin N.A., 2002. The features of the diseases of the
cardiovascular system of liquidators of the consequences of the Chernobyl’s
catastrophe and of the persons who live on polluted territories. Labor and Industr.Ecolog. Med., № 7, pp. 22 – 25 (in Russian).
Baeva E.V., Sokolenko V.L., 1998. Expression of T-cellular superficial marker by the
lymphocytes of persons exposed to the small dozes of radiation. Immunology, № 3,
pp. 56 – 59 (in Russian).
Bazarov V.G., Belyakova I.A., Savchuk L.A., 2001. Cerebral dynamic under the
experimental vestibular stimulation among liquidators of the catastrophe
consequences. Jour. Ear, Nose and Throat Illness, № 4, pp. 1 – 5 (in Ukrainian).
Bazyka D., Chumak A., Byelyaeva N. 2003. Immune cells in Chernobyl radiation workers
exposed to low dose irradiation. Int. J. Low Radiation, vol. 1, pp. 63 -75.
Bebeshko V.G., Kovalenko A.N. (Eds.). 1999. Medical Consequences of Chernobyl
nuclear power station accident. Book 2. Clinical aspects of the Chernobyl
catastrophe. Kiev, “MEDECOL” interdisciplinary Scientific and Research Centre
BIO-ECOS, 399 p. (In Russian).
Begenar V.F. 1999. Immune hematological and cytogenetic aspects of the impact of small
dozes of radiation on women organism. Russ. Associate Obstetric - Gynecol.
Herald, № 1, pp. 33 – 36 (in Russian).
Bero M.P., 1999. The distribancies of sexual health of male liquidators. Jour. Psych. Med.
Psychology, № 1(5), pp. 64 – 68 (in Russian).
Bol’shov L.A., Aruthyunyan P.V., Linge I.I., Barkhudarov R.M., Osypyants I.A.,
Gerasymova N.V., Blinov B.K., Marchenko T.A., Zyborov A.M., 1999.
Chernobyl’s catastrophe. Results and problems of overcoming of its consequences in
ibrae.
ac.
Ru
Russia
1986-1999.
(www.
/russian/chernobyl/nat_rep_99/13let_text.html) (in Russian).
Chernobyl: medical consequences (in 18 years after). 2004. LigaBisnessinform, 22 april
Chekyna S.Yu., Pashkova T.L., Kopylev I.D., Chernyaev A.L., Samsonova M.V.,
Aysanov Z.R., Chuchalin A.G. 2002. Functional state of the respiratory system of
the liquidators of the Chernobyl’s catastrophe: the results of seven years observation.
Pulmonology, № 4, pp. 66 -71(in Russian).
Chuchalin A.G. 1996. Pathology of respiratory organs among the liquidators of the
consequences of the Chernobyl’s catastrophe. Therapeutic archives, vol.68, № 3, pp.
5-7 (in Russian).
Gajeeva T.P., Tchekotova E.V., Krotkova M.V. 2001. The state of the immunity of male
liquidators after the Chernobyl’s catastrophe. 11th Intern. Symp. Bioindicators.
"Modern problems of Bioindication and Biomonitoring", Syktuyvkar, 17-21
September, 2001. Syktuyvkar, p. 31 (in Russian).
Gerasymova N.V., Blinov B.K., Marchenko T.A., Zyborov A.M., Onischenko G.G.,
Ivanov S.I., Permynova G.S., Goncharik N.V., Kurganov A.A., Bol’shov L.A.,
Aruthyunyan P.V., Linge I.I., Barkhudarov R.M., Belyaev S.T., Tsib A.F.,
160
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Ivanov V.K., Alexahin R.M., Il’in L.A., Izrael Yu.A. 2001. Chernobyl’s
catastrophe. Results and problems of overcoming of its consequences in Russia
1986-2001. Russian National Report , RF Ministry of Emergencу Situation,
Moscow, 39 p. (www.ibrae.ac.ru/russian/nat_rep2001.html) (in Russian).
Golubchykov M.V., Mikhenko Yu. A., Babynets A.T. 2002. The changes in the state of
health of the population of Ukraine in post-catastrophe period: Reports 5-th Anual
sci. pract. Conference «To 21 century with safety nuclear technology», Slavytich,
12-14 April, 2001, Scientific and technological aspect of the Chernobyl, № 4, pp.
579-581 (in Ukrainian).
Goncharova R.I. 2000. Remote consequences of the Chernobyl Disaster: Assesnment
After 13 Years. In: E.B. Burlakova (Ed.). Low Doses Radiation: Are they
Dangerous? NOVA Sci. Publ., pp. 289 – 314.
Gylmanov A.A., Molokovich N.I., Sadykova F.H. 2001. Health state of liquidators’
children. Diagnostics, treatment and rehabilitation.
Materials Intern. Interdisciplinary Sci.- Practical Conf., devoted by 15th anniversary of the Chernobyl’
catastrophe, Kazan’, 25 - 26 April, 2001. Кazan’, pp. 25 – 26 (in Russian).
Demyna E.A., Klyushin D.A., Petunin Yu.I. 2002. Cytogenetic and carcinogenic effects
of small dozes on liquidators of the consequences of the Chernobyl’s catastrophe.
Abstracts, 3rd Intern. Symp. “Mechanism of the Ultra-Law doses action”, Moscow, 3
- 6 December, 2002, Moscow, p. 71 (in Russian).
Dregyna L.B. 2002. Clinic-laboratory estimations of the state of adaptive-regulation
systems of liquidators in remote times. Doc. Thesis, Biol. Sci., All-Russian Center
Emergency and Radiation Medic., Sank- Petersburg, 25 p. (in Russian).
Drujynina I.V. 2004. The condition of the bone tissue of jaws of persons who took part in
the liquidation of the consequences of the Chernobyl’s catastrophe. Materials Interregion. InterUniversities Sci. Students Conf., Perm’, 5-7 April, 2004. vol. 1, Perm’ Izhevsk, pp. 53 -54 (in Russian).
Dubivko G.F. Karatay Sh.S. 2001. Dependence of the sexual function of a man from the
stressors and radioactive impacts. Diagnosis, cure and rehabilitation suffering in
emergency cases. Materials Intern. Interdisciplinary Sci.-practical Conf., devoted by
15th Anniversary of the Chernobyl’ Catastrophe, Kazan’, 25 - 26 April, 2001 ,
Kazan’, pp. 113 -117 (in Russian).
Grebenyuk A.N., Bejenar’ A.F., Antushevitch A.E., Lutov R.V. 1999. About estimation
of the immune statue of women after radiation and chemical factors impact.
Military.-Med. Jorn., № 11, pp. 49 – 54 (in Russian).
Ibragymova A.I. 2003. Clinic data about the genotoxic influence of the ionizing radiation.
Russ. Herald of Perinatology and Pediatric, vol. 48, № 6, pp. 51 – 55 (in Russian).
Imanaka T. (Ed.). 2002. Recent Research Activities about the Chernobyl NPP Accident in
Belarus, Ukraine and Russia. Recent Research Activities about the Chernobyl
Accident in Belarus, Ukraine and Russia. Kyoto University Research Reactor
Institute. Kurri-Kr-79, July
Islamova A.R. 2004. Morbidity with the malignant neoplasms of female liquidators. Doc.
Thesis, Med. Sci., Obninsk, Med. Radiolog. Sci. Center, 19 p. (in Russian).
Ivanov V.K., Matveenko E.G., Birjukov A.P. 1996. Analysis of a new revealed sickness
of the liquidators of Kalugskaya province. «Chernobyl Legacy», Mater. Sci.Practical Conf. "Med.-Psycholog., Radioecological and Social-Economical aspects
of liquidation of consequences oa Chernobyl Accident in Kaluga Province", Kaluga Obninsk, 2, pp. 233 – 234 (in Russian).
Ivanov, E.P. et al. 1997. Chernobyl registry and hematological surveillance of Belarus
liquidators. p. 171-192 in: Sixth Symposium on Chernobyl-Related Health Effects,
161
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Tokyo, 10-11 December.
Ivanov V.K., Tsyb A.F., Nilova E.V. 1997. Cancer risks in the Kaluga oblast of the
Russian Federation 10 years after the Chernobyl accident. Radiat. Environ. Biophys.
Vol. 36, pp. 161-167.
Ivanov V.K., Rastopchin E.M., Gorsky A.L. 1998. Cancer incidence among liquidators
of the Chernobyl accident: solid tumors, 1986-1995. Health Phys., vol. 74, pp. 309 315.
Ivanov V.K., Tsib A.F., Ivanov S.I., 1999. Liquidators of the Chernobyl’s catastrophe:
radiation-epidemiologic analysis of medical consequences. Moscow, Publ.
“Galanis”, 312 p. (in Russian).
Ivanov V., Tsyb A., Ivanov S., Pokrovsky V. 2004. Medical Radiological Consequences
of the Chernobyl Catastrophe in Russia. Estimation of Radiation Risk. St.
Petersburg, Publ. “Science”, 388 p. (in Russian).
Il’in L.A., Kryuchkov V.P., Osanov D.P., Pavlov D.A., 1995. Levels of the radiation of
the liquidators in 1986-1987 and the verification of dosimetric data. Radiat. Biol.
Radioecology, vol. 35, 6, pp. 803 – 827 (in Russian).
Javoronkova L.A., Rygov B.N., Barmakhova A.B., Kholodnova N.B., 2002. Features of
the disturbances of EEG and of cognitive functions after the impact of the radiation.
Russ. Acad. Sci. Reports, vol. 386, № 3, pp. 418 – 422 (in Russian).
Kamarenko D.I., Glukhen’kiy E.V., Polyakov O.B. 2002. Structural changes of the
pancreas of the liquidators of the Chernobyl’s catastrophe, which were revealed by
the prospective sonographic data in the remote period. Ukran. J. Hematology
Transfusiol., № 5, pp. 28 – 32 (in Ukrainian).
Karamullin M.A., Sosukin A.E., Shutko A.N., Nedoborsky K.V., Yazenok A.V.,
Ekymova L.P., Grischuk A.V., Babhak A.V. 2004. Importance of the factor of the
doze of the radiation for the forming of the sickness in the remote period among the
participants of the liquidation of the consequences of the Chernobyl’s catastrophe
according of their age. Abstracts, “Actual Questions of Radiation Hygiene”, Sci.Practical Conf., Sankt-Peterburgh, 21 - 25 June, 2004, Sankt-Peterburg, pp. 170 –
171 (in Russian).
Karpova I.S., Koretskaya N.V., 2003. The influence of the character of the radiation doze
on the activity of the receptor-lectin reaction at liquidators of the Chernobyl’s
catastrophe. Biopolymers and Cell, vol. 19, № 2, pp. 133 -139 (in Ukrainian).
Kirke L. 2002. Early development of some diseases among the liquidators of the
Chernobyl’s catastrophe. Reports, 7th Intern. Sci.-Practical Conf. “Aging Pacient.
Quality of Life”, Moscow, 1 - 3 October, 2002, Hospital Gerontology, vol. 8, № 8, p.
83 (in Russian).
Kharchenko V.P., Zubovsky G.A., Kholodnova N.B. 1995. Changes in the brains among
the liquidators of the consequences of the Chernobyl’s catastrophe. Herald of
Roentgenlogy and Radiology, № 1, pp. 11 – 14 (in Russian).
Kholodova N.B., Zubovsky G.A. 2002. Polymorbidity like a syndrome of the premature
aging in the remote period after the irradiation with the small dozes. Reports, 7th
Intern. Sci.-Practical Conf. “Aging Pacient. Quality of Life”, Moscow, 1 - 3 October,
2002, Hospital Gerontology, vol. 8, № 8, p. 86 (in Russian).
Klimenko D.I., Snysar I.A., Samophalova E.G. 1996. Immunologic reactivity and
functional state of hearing and of vestibular analyzer of liquidators of the
Chernobyl’s catastrophe. Remote consequences of irradiation for immune and
haemopoetic systems. Abstarcts, Sci.-Pract. Conf., 7-10 May, 1996, Kiev, pp. 29 –
30 (in Ukrainian).
162
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Komarenko D.I., Polyakov O.B. 2003. Post-radiational pancreatopathy: remote
consequences of the ionizing radiation. Gastro-Enterology Herald, № 1, pp. 31 -35
(in Ukrainian).
Korobko I.V., Korit’ko S.S., Blet’ko T.V., Korbut I.I. 1996. Features of functioning of
the interferon system among the liquidators. Immunology, № 1, pp. 56 – 58 (in
Russian).
Krasylenko E.P., Eler Ayad M.S. 2002. Age features of the intersystem correlation of the
cerebral hemodynamics among persons with high genetic or ecological risks of the
development of the cerebro-vascular pathology. Aging and Longevity Problems,
vol. 11, № 4, pp. 405 – 416 (in Russian).
Kuznetsova S.M., Krasylenko E.P., Kuznetsov V.V. 2004. Vascular diseases of the brain
and cerebral blood circulation of the participants of the liquidation of the
Chernobyl’s catastrophe. Hospital Gerontology, vol. 10, № 8, pp. 18 – 28 (in
Russian).
Law. 1996. Federal law “about the introduction of changes and of additions into the Law of
Russian Federation “About the social protection of citizens exposed to the influence
of the radiation because of the catastrophe on Chernobyl NPP”, December 11, 1996.
Leberman A.N. 2003. Radiation and reproductive health. Sankt-Peterburg, Publ. “New
Century”, 225 p. (in Russian).
Ledoshchuk B.A., Gudzenko N.A. 2001. Haemoblastosis in liquidators: 15 years after
Chernobyl catastrophe. Main results and perspective. In: International Conference
“Fifteen Years after the Chernobyl Accident. Lessons Learned”, Kiev,
Chornobylinterinform. pp. 3-10 (in Russian).
Loganovsky K. Medical consequences of the Chernobyl’s catastrophe: what do we know
after 19 years? (www.chornobyl.net/ru/261/prn/) (in Russian).
Loganovsky K. N. 1999. Clinic-medical aspects of the psychiatric consequences of the
Chernobyl's catastrophe. Social and Medical Psychiatry, vol. 9, 1, pp. 5 – 17 (in
Russian).
Loganovsky K.M., Kovalenko O.M., Yur’ev K.L., Bomko M.O., Antypchuk K.Yu.,
Denisjuk N.V., Zdorenko L.l, Rossokha A.P., Chornij A.G., Dubrovena G.V.
2003. Verification of the organic affection of the brain in the remote period of the
acute radiation sickness. Ukrainian Medical Annual Report, № 6, pp. 70 – 78 (In
Ukrainian).
Lushnykov E.F., Lantsov S.I. 1999. Mortality of liquidators in Kalujskaya province in 10
years after the catastrophe on Chernobyl’s NPP. Med. Radiol. and Radiat. Safety,
vol. 44, № 2, pp. 36 – 44 (in Russian).
Lyaginskaya A.M., Osypov V.A., Smirnova O.V., Isichenko I.B., Romanova S.V. 2002.
Function of reproduction of the liquidators of the consequences of the Chernobyl’s
accident. Med. Radiol. and Radiat. Safety, vol. 47, № 1, pp. 5 – 10 (in Russian).
Lyashko L.I., Tsib A.F., Sushkevich G.N. 2000. Radioactive nuclide’s methods in the
diagnostics of the thyroid gland diseases among the liquidators of the Chernobyl’s
catastrophe. Intern. Conf. "Modern Problems of Nuclear Medicine and Radiopharmacology", 2nd Congr. Russ. Soc. Nuclear Medicine, Obninsk, 23 - 27 October,
2000, Obninsk, pp. 95 – 96 (in Russian).
Maksioutov M.M. 2002. Radiation Epidemiological Studies in Russian National Medical
And Dosimetric Registry: Estimation of Cancer and Non-Cancer Consequences
Observed among Chernobyl Liquidators. In: Imanaka T. (Ed.). Recent Research
Activities about the Chernobyl Accident in Belarus, Ukraine and Russia. Kyoto
University, Research Reactor Institute, Kyoto. Pp. 168 – 187.
163
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Maljuk E.S., Bogdantsova E.N. 2001. The features of the appearance and of the clinical
course of psoriasis of the liquidators of the consequences of the Chernobyl’s NPP.
Collect. Of Sci. Papers «185 years Krasnodar Region. Med. Hospital, named Prof.
S.V. Otchapovsky», Krasnodar, p. 134 (in Russian).
Marapova L.A., Hytrov B.Yu. 2001. The stomatologic status of liquidator’s children.
«Diagnostic, cure and rehabilitation of sufferers during emergency operations»,
Materials Intern. Interdisciplinary Sci.-Pract. Conf., devoted by 15th anniversary of
the Chernobyl catastrophe”. Kazan’, 25 - 26 April, 2001, Kazan’, pp. 193 -195 (in
Russian).
Matsko M.P. 1999. Current state of Epidemiological Studies in Belarus about Chernobyl
Suffers. In: Imanaka T. (Ed.). Research Activities about the Radiological
Consequences the Chernobyl NPS Accident and Social Activity the Suffers by the
Accident. Kyoto University, Research Reactor Institute, Kyoto, pp.127 -138.
Matvienko V.N., Javoronok S.V., Sachek M.M. 1997. Flowing cytometric analysis of
subpopulations of lymphocytes of the peripheral blood of the liquidators. «Med.Biol. Effects and ways to overcome of the consequences of the Chernobyl NPP
Accident», Collect. of Sci. Papers, devoted by 10th anniversary of Chernobyl NPP’
Accident. Minsk- Vitebsk, pp. 34 – 36 (in Russian).
Maznik N.A., Vinnykov V.A. 1997. The dynamics of the Cytogenetic effects in the
lymphocytes of the peripheral blood of liquidators of the Chernobyl’s catastrophe.
Genetics and Cytology, vol. 31, № 6, pp. 41 – 46 (in Russian).
Maznik N.A., Vinnykov V.A., Maznik V.S. 2003. The estimation of the distribution of
individual dozes of the radiation of the liquidators of the consequences of the
Chernobyl’s catastrophe, according to data of the cytogenetic analysis.Radiat. Biol.,
Radioecology, vol. 43, № 4, pp. 412 – 419 (in Russian).
Medical consequences of the Chernobyl’s catastrophe. 1995. The results of the IPHECA
Pilot Projects and National Programmes. Sci. Report, WHO, Geneva, 560 p.
Mel’nikov S.B., Koryt’ko S.S., Greschenko M.V. 1998. The dynamic of the cytogenetic
status of the liquidators. Public Health, № 2, pp. 21 – 23 (in Russian).
Mel’nov S.B., Koryt’ko S.S., Aderyho K.N., Kondrachuk A.N., Shymanets T.V.,
Nikonovich S.N. 2003. The estimation of the immunological status of liquidators of
1986-87, in remote periods after the participating in catastrophe works. Immunopathology, Allergology and Infectology, № 4, pp. 35 – 41 (in Russian).
Mitryaeva N.A. 1996. The hypothalamo-pituitary-adrenal axis of the liquidators of the
consequences of the Chernobyl’s NPP. Med. Radiology and Radiol. Safety, vol. 41,
№ 3, pp. 19 – 23 (in Russian).
Mitjunin A. 2005. National consequences of the liquidations of the Chernobyl’s
catastrophe. Atomic Startegy at ХХI Century, № 1, 22 p. (in Russian).
Nekytina N.V. 2002. Study of the mineral density of the bone and of the intensity of the
exchange of the bone tissue of the liquidators of the consequences of the
Chernobyl’s NPP. Abstarcts, 6th Region. Conf. Junior Researchers of Volgograd
Province, Volgograd, 13 -16 November, 2001 , Volgograd, pp. 87 – 88 (in Russian).
Noskov A.I. 2004. Visceral organs’ pathologies in Chernobyl’ NPP liquidators under 15th
years observations. Materials Sci. - Pract. Conf. with Intern. Participation and
Workshop for Junior Scientists “Modern achievements of the fundamental sciences
for solving actual medical problems”, Astrakhan’, pp. 272 – 274 (in Russian).
Novykova N.S. 2003. Clinic-immunological characteristics of the liquidators of the
consequences of the Chernobyl’s NPS in the remote period. Doc. Thesis, Med. Sci.,
Novosibirsk State Medical Academy, Novosibirsk, 22 p. (in Russian).
164
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Nyagu F.I., Loganovsky K.N. 1998. Nero-psychiatric effects of ionizing irradiation. Kiev,
Publ. Chernobylinterinform, 350 p. (in Russian).
Nyagu A.I., Loganovsky K.N., Chuprovsky N.U. et al. 1999. Neuropsychiatric effects in:
V.G.Bebeshko, A.N.Kovalenko (Eds). - Book 2. Clinical aspects of the Chernobyl
catastrophe. - K.: “MEDECOL” interdisciplinary Scientific and Research Centre
BIO-ECOS, Kiev, pp. 154 -186 (In Russian).
Oganesyan N.M., Asryan K.V., Mirydjanyan M.I., Petrosyan Sh.M., Pogosyan A.S.,
Abramyan A.K. 2002. Estimation of medical consequences of low doses impact on
Armenian liquidators of Chernobyl’ accident. Abstracts, 3rd Intern. Symp. “
Mechanisms of UltraLow Doses action”, Moscow, 3 – 6 December, 2002, p. 114 (in
Russian).
Okeanov A.E., Cardis E., Antipova S.I. 1996. Health status and follow-up of the
liquidators in Belarus. In: “The Radiological Consequences of the Chernobyl
Accident”. Proc. 1st Intern. Conf., Minsk, Belarus, March 1996, pp. 851 – 859.
Okeanov A.E., Sosnovskaya E.Y., Priatkina O.P. 2004. A national cancer registry to
asses trends after the Chernobyl accident. Swiss Med. Weekly, 134, pp. 645 – 649.
Onyschenko N.P., Kokueva O.V., Sof’ina L.I., Hosroeva D.A., Litvynova T.N. Method
of the forecasting of the extent of the risk of the development of the chronic
pancreatitis among the liquidators of the consequences of the Chernobyl’s NPP.
Patent 2211449 Russia, MPK {7} G-1N 33/48, G01N 33/50 / - N 2001114065/14;
Declaration from 25.05.2001; Publication data 27.08.2003, Bull. N 24.
Petrova I.N. 2003. Clinical meaning of the micro circular irregulations under the morbus
hypertonicus among the liquidators of the consequences of the Chernobyl’s NPP.
Doc. Thesis, Med. Sci., Kuban State Medical Academy, Krasnodar, 22 p. (in
Russian).
Pilinskaya M.A. 1999. Cytogenetic effects in the somatic cells of faces like the biomarkers
of the influence of ionizing radiation in small dozes of persons who suffered in
consequence of the Chernobyl’s catastrophe. Intern. Jour. Radiat. Med. № 2, pp. 60
– 66.
Pilinskaya M.A., Dybsky S.A., Dybs’ka O.B., Pedan L.R. 2003. Cytogenetic
examination of the participants of the liquidation of the Chernobyl’s catastrophe
consequences with FISH method. Ukran. Medical Science Academy Reports, vol.
9, № 3, pp. 465 – 475 (in Ukrainian).
Ponomarenko B.M., Bobyl’ova O.O., Prokleena T.L. 2002. Present-day state of
children’s health born by persons suffered in Chernobyl’s catastrophe. Ukranian
Herald of social hygiene and organization of public health, № 4, pp. 19 – 21 (in
Ukrainian).
Popova O.V., Shmarov D.A., Budnik M.I., Kozhinets G.I. 2002. The study of NMR
relaxation of blood plasma under the influence of ecological factors of extra-slight
intensity. Abstracts, 3rd Intern. Symp. "Mechanisms of Ultra-Low dose action”,
Moscow, 3 - 6 December, 2002, Мoscow, p. 124 (in Russian).
Potapnev M.P., Kuz’menok O.I., Potapova S.M., Smol’nykova V.V., Mislitsky V.F.,
Rjeutsky V.A., Vasylevskaya T.A., Vahsukhina L.V. 1998. Functional
insufficiency of T-cell immunity among the liquidators in 10 years after the
catastrophe on Chernobyl NPP. Belarus National Academy Sci. Reports, vol. 42, №
4, pp. 109 – 113 (in Russian).
Preebylova N.N., Sydorets V.M., Neronov A.F., Ovsyannikov A.G. 2004. The results of
the examination of liquidators of the consequences of the Chernobyl’s catastrophe.
Collect. of Papers, 69th Final Sci. Session Kursk State Medical University and Dept.
165
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Med.-Biol. Sci. Central- Black Soil Sci. Center, Russ. Acad. Med. Sci., Kursk, part
2, pp. 107 – 108 (in Russian).
Problems of the ensuring of the ecological and of the radiation- sanitary safety of the
regions suffered from the radiation pollution. 2002. «Russian Ecological Safety».
Materials Ineragency Comm. Of Ecological Safety, RF Security Council (September
1995 – April 2002), part 4, Moscow, pp. 178 – 203 (in Russian).
Prokopenko N.A. 2003.Patholgy of the cardiovascular and of the nervous systems as a
consequences of the synergism of radiation affection and of the psycho-emotional
tension of the persons suffered from the catastrophe on the Chernobyl’s NPP. Aging
and Longevity Problems, vol. 12, № 2, pp. 213 – 218 (in Russian).
Pryayazhnyuk A.E., Greeschenko V.G., Fedorenko Z.P., Fedorenko V.A., Gulak L.O.,
Fuzik N.N., Slypenjuk E.M.,Bormasheva I.V. 1999. Epidemic study of the
malignant neoplasms among the liquidators of the consequences of the Chernobyl’s
catastrophe. Intern. Jour, Radiat. Med., № 2, pp. 42 – 50 (in Russian).
Regulation of the Constitutional court of RF about the case of checking of the
constitutionality of some states of the 1st asset of the Federal law from the 24th
November 1995 “About the carrying in of changes and of additions into the Law of
RF “About the social guard of citizens exposed to the influence of the radiation
because
of
the
Chernobyl’s
catastrophe”.
(http://www.ksrf.ru/doc/postan/p18_97.htm) (in Russian).
Romanenko N.I., Bobrova V.I., Nemchinova T.G., Golovchenko Yu. I. 1995. The
features of the influence of small dozes of ionizing radiation on the condition of
nervous system. Materials Intern. Conf. 24 – 28 May, 1995, Kiev, Ukraine, Kiev, p.
264 (in Russian).
Romanenkova V. 1998. Russia – Chernobyl – Liquidators – Health. Joint Lent of News,
TASS, 24 April, 1998 (rv/lp 241449 APR 98).
Romanova G.D. 2002. Features of the cerebral hemodynamics and of the functional state
of brain among liquidators of the consequences of the Chernobyl’s catastrophe. Doc.
Thesis, Med. Sci., All-Russian Сenter for Extreme and Radiat. Medicine, SanktPeterburg, 17 p. (in Russian).
Rud’ L.I., Dubinkyna V.O., Petrova I.N. Kolomijtseva N.E. 2001. State of the blood
stream in the supratrochlear artery and of the vegetative regulation under the arterial
hypertension among the liquidators of the consequences of the Chernobyl’s
catastrophe. «New Thech. of Eyes’ Micro-Surgery”, Materials 12th Sci.- Pract..
Conf., Orenburg, 14 November, 2001, Orenburg, pp. 298 – 299 (in Russian).
Rumyantseva G.M., Chinkina O.V., Levina T.M. 2002. Psychosomatic aspects of the
development of the psychical violations of the liquidators of the consequences of the
Chernobyl’s catastrophe. Psychotherapy and Psychopharmacology, vol. 4, № 1, pp.
1 – 5 (www.consilium-medicum.com/media/psycho/02_01/7.shtml) (in Russian).
Seenyakova O.K., Rjeutsky V.A., Vasylevich LM. 1997. The analysis of some indexes of
the state of health of children of the participants of the liquidation of the Chernobyl’s
catastrophe consequences. “Actual Questions Med. Rehab. Suffers of Chernobyl’
Catastrophe”, Materials Sci.-Pract. Conf., devoted 10th anniversary Republ. Hospital
of Radiat. Medicine (Minsk, 30 June, 1997), Minsk, pp. 44 – 45 (in Russian).
Serduk A.M., Bobyleva O.A. 1998. Chernobyl and the health of the Ukraine population.
2nd Intern. Conf. «Remote med. Consequences of the Chernobyl Catastrophe», Kiev
Ukraine, 1 - 6 June, 1998 , Kiev, p. 132 (in Russian).
Shevchenko V.A., Semov A.B., Akaeva E.A. 1995. Cytogenetic effects among the
persons suffered from the catastrophe on the Chernobyl’s NPP. Radiat. Biology,
Radioecology, vol. 35, # 5, pp. 646 – 653 in Russian).
166
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Shykalov V.F., Usatiy A.F., Sevintsev Yu.V., Kruglova G.I., Kozlova L.V. 2002.
Analysis of sweep-biological consequences of the Chernobyl’s catastrophe for the
liquidators – employees of Russian Scientific Center “Kurchatov’s Institute”. Med.
Radiology and Radiat. Safety, vol. 47, № 3, pp. 23 – 33 (in Russian).
Shkrobot C.I., Gara I.I., Salij Z.V., Furdela M.Ya. 2003. Features of the clinical passing
of the vegetative disfunction and the state of the mineral thickness of bone tissue
among the liquidators of the consequences of the Chernobyl’s catastrophe. Scientific
herald Ternopol. State Med. Academy, № 2, pp. 80 – 81 (in Ukrainian).
Shubik V.M. 2002. Immunologic changes in the remote period after the influence of small
doses of ionizing radiation. Abstarcts, 3rd Intern Symp. "Mechanisms of Ultra-Low
Dose action", Мoscow, 3 - 6 December, 2002, Мoscow, p. 154 (in Russian).
Sokolova A.V. 2000. The diagnostics and the treatment of the vegetative sensor
polyneuropathy of the liquidators of the consequences of the Chernobyl’s
catastrophe. Doc. Thesis, Med. Sci. Perm’ State medical Academy, Perm’, 37 p. (in
Russian).
Soloshenko E.N. 2002. State of immune homeostasis among the sick with spread
dermatosis, which were exposed to the radiation during the Chernobyl’s catastrophe.
Ukranian Jour. Hematology and Transfusiology, № 5, pp. 34 – 35 (in Ukrainian).
Stepanenko I.V. 2003. Dependence of the changes of the immunologic indexes on the
blood pH among the liquidators of the consequences of the Chernobyl’s catastrophe.
Laborat. Diagnost., № 3, pp. 21 – 23 (in Russian).
Strukov E.L. 2003. Endocrine control under the cardiovascular diseases and under some
disfunctions of endocrine organs among persons exposed to the influence of the
factors of Chernobyl’s catastrophe. Doc. Thesis, Med. Sci. All-Russian Center for
Extreme and Radiat. Medicine, Sankt-Peterburh, 42 p. (in Russian).
Sushkevich G.N., Tsib A.F., Lyasko L.I. 1995. The level of neuropeptides among the
liquidators of the consequences of the Chernobyl’s catastrophe. «Actual and Future
disturbances of psychical health after nuclear catastrophe in Chernobyl», Materials
Intern. Conf., Kiev, 24 - 28 May 1995, Kiev, “Chernobyl Doctors” Assoc., p. 70. (in
Russian).
Svirnovsky A.I., Shamanskaya T.V., Bakun A.V. 1998. About the hematological and
cytogenetic indexes of the persons suffered from the catastrophe on the Chernobyl’s
NPP. 2nd Intern Conf. “Remote Medical Consequences of the Chernobyl
catastrophe», Kiev, Ukraine, 1 - 6 June 1998, Kiev, p. 360 (in Russian).
Talalaeva G.V. 2002. Change of the biological time of the liquidators of the consequences
of the Chernobyl’s catastrophe. Herald of Kazakh National Nuclear Centre, # 3, 11
p. (in Russian).
Tataurschykova N.S., Seedorovich I.G., Ardabatskaya T.B., Zelenskaya N.S.,
Polyushkina N.S. 1996. The analysis of the prevalence of the allergic pathology
among the liquidators of the consequences of the Chernobyl’s catastrophe.
Hematology and Transfusiology, vol. 41, № 6, pp. 18 – 19 (in Russian).
Tlepshukov I.K., Baluda M.V., Tsib A.F. 1998. Change of the haemostatic homeostasis
among the liquidators of the consequences of the Chernobyl’s catastrophe.
Hematology and Transfusiology, vol. 43, № 1, pp. 39 – 41 (in Russian).
Troshina O.V. 2004. The features of the cerebral hemodynamics and of the peripheral
neuromotor apparatus in the remote period among the liquidators of the
consequences of the Chernobyl’s catastrophe. Doc. Thesis, Med. Sci., Institute of
Total pathology and pathophysiol., Moscow, 23 p. (in Russian).
Tseloval’nykova N.V., Balashov N.S., Efremov O.V. 2003. Prevalence of the diseases of
the respiratory organs among the liquidators of the consequences of the Chernobyl’s
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
catastrophe. «Prophylactics as base for modern public health», Materials 38th
Interregional Sci.-Pract. Conf. of Physicians, Ul’yanovsk, pp. 133 -135 (in Russian).
Tsib A.V., Ivanov V.K. 2000. Medical consequences of the Chernobyl’s catastrophe:
forecast
and
factual
data
of
the
National
register
(www.ibrae.ac.ru/russian/register/register.html) (in Russian).
Tsygan V.N., Dudarenko S.V., Antonov V.M., Rosanov M.Yu., Vasil’eva N.A. 2003.
Mechanisms of formations of the psychosomatic disorders under low doses impact.
Modern Medicine. Theory and Practice, № 5, pp. 16 – 21 (in Russian).
Tukov A.R., Shafransky I.L., Kleeva N.A. 2002. Comparison of the indexes of peripheral
blood and of the doze of external radiation among male liquidators of the
consequences of the Chernobyl’s catastrophe. Med. Radiol. And Radiat. Safety, vol.
47, № 6, pp. 27 – 32 (in Russian).
Tymonin L. 2005. Letters from the zone. Tol’yatty Publ. «Agny», 199 p. (in Russian)
Vartanyan L.S., Gurevich S.M., Kozachenko A.I., Nagler L.G., Burlakova E.B. 2002.
Remote consequences of the influence of small ionizing radiation dozes on the
condition of enzymatic antioxidant system of people. Reports, 3rd Intern. Symp.
"Mechanisms of the Ultra-Low dose action", Moscow, 3 - 6 December, 2002.
Radiat. Biology. Radioecology, vol. 43, № 2, pp. 203 – 205 (in Russian).
Yakushin S.S., Smirnova E.A. 2002. Ecological and medical aspects of the radioactive
nuclides pneumopathy. Abstracts, All-Russian Sci-Thech. Conf. Students, Young
Scientists and Specialists, Ryazan’, pp. 2 – 3 (in Russian).
Zabolotniy D.I., Shildovskaya T.V., Rymar V.V. 2001. Hemodynamic irregulations in
the carotid system and in vertebrobasilar one among the victims in the result of the
Chernobyl’s catastrophe. Jour. Ear, Nose and Throat Illness., № 4, pp. 5 – 13 (in
Ukrainian).
Zagradskaya O.V. 2002. Clinic-metabolite aspects of the remote consequences of the
impact of the radiation among liquidators suffering from CHD. Doc. Thesis, Med.
Sci., Perm’ Styate Med. Academy, Perm’ 24 p. (in Russian).
Zak K.P., Butenko Z.A., Mikhaylovskaya E.V., 1996. Hematological, immunological
and molecular-genetic monitoring of the participants of the liquidation of the
catastrophe on the Chernobyl’s NPP. Abstracts, «Remote Consequences Changes in
Immune and Haemopoet. systems», Sci.-Pract. Conf., Кiev, 7-10 May 1996, Kiev,
pp. 12 – 13 (in Ukrainian).
Zubovsky G.A., Malova Yu.V. 2002. The Features of the aging of liquidators organisms.
Reports, 7th Intern. Sci.-Pract. Conf. "Aging Patient. Quality of Life", Moscow, 1-3
October 2002, Medical Gerontology, vol. 8, № 8, с. 82 (in Russian).
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CHAPTER 10
Did Acute Radiation Syndrome Occur Among the Inhabitants of the 30 km
Zone?
Tetsuji Imanaka
Research Reactor Institute, Kyoto University
Kumatori-cho, Osaka 590-0494 Japan, [email protected]
Introduction
According to the Chernobyl Forum report of 2005(1), 28 persons died of acute radiation
syndrome (ARS) as a result of the Chernobyl NPP accident. These deaths were all among
firemen and NPP staffs who worked at the time of the accident and, it was claimed, there
was no ARS among inhabitants who were living around the Chernobyl NPP at the time of
the accident. This formal opinion has been repeated many times since the first IAEA
conference about the Chernobyl accident in August 1986.(2-4) The average external doses of
evacuees from the 30-km zone around the Chernobyl NPP were estimated to be 20 and 30
mSv, respectively, for Ukrainian and Belarusian territories. Maximum individual dose was
estimated to be about 400 and 300 mSv for Ukrainian and Belarusian evacuees,
respectively. Considering a conventional conception that ARS only appears in cases of
radiation exposure over 1,000 mSv, they concluded that no ARS could occur among the
evacuees from the 30-km zone around the Chernobyl NPP.
On the other hand, after the collapse of USSR, evidence appeared in several publications
that ARS was observed among inhabitants around Chernobyl. In 1992 Yaroshinskaya
disclosed the secret protocols of the Soviet Communist Party containing information about
a number of ARS cases among inhabitants around Chernobyl that were reported to the
Operative Group of Politic Bureau of Central Committee of the Communist Party in
Moscow.(5,6) Excerpts of the information from the protocols are summarized in Table 1.
Although the numbers of deaths and serious illnesses described in the protocols closely
correspond to those numbers among firemen and plant staff, ARS cases among children
means that there were many additional cases of ARS among inhabitants around the
Chernobyl NPP. It is also noteworthy that, according to the protocol, on May 6 two infants
were hospitalized at No. 6 Hospital in Moscow - the national center for treatment of ARS in
the USSR. Lupandin also reported ARS cases among inhabitants after he investigated in
1992 medical records that were kept at the Central Hospital of the Khoiniki district, in the
Gomel region of Belarus.(7,8) He reported 8 cases with clear ARS and 82 cases with
syndromes considered to be related to radiation exposure.
In this article the possibility of ARS among inhabitants is discussed again, from the point
of radiation exposure of the people living around the Chernobyl NPP at the time of the
accident.
Radioactivity release and contamination
The explosion at the Chernobyl-4 reactor took place at 01:23 on April 26, 1986. Witness
said that there were several sequential explosions, like fireworks in the night sky. Then the
subsequent fire began at the reactor and continued for ten days or more, releasing huge
amounts of radioactivity into the surrounding environment. According to the USSR report
in 1986,(3) a large amount of radioactivity continued to be released up to May 6th, daily
release of which is shown in Fig. 1. It should be noted that the released amount in Fig. 1 is
decay-corrected to the activity on May 6. That is, considering decay-out due to the half-life
of the short-lived radionuclides, the actual release on the first day was about 6 times greater
than shown in figure in Fig. 1. On the second and third day they were 4 - 5 times greater
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than in Fig. 1. So, we can say that radioactive release in the first three days was far more
intensive than the impression given in Fig. 1.
Table 1. Excerpts of description from the secret protocols of the Operative Group of the
Politic Bureau of the Central Committee of the Communist Party of the Soviet Union.
Date
1986
May 4:
<Description about the health state of people>
By the situation on May 4, 1,882 people are hospitalized in total. Total
number of examined people reached 38,000 persons. Radiation disease of
various seriousness appeared with 204 persons, including 64 infants.
Total number of hospitalized people reached 2,757 persons, including 569
May 5:
children. Among them, 914 persons have symptoms of radiation disease. 18
persons are in very serious state and 32 persons are in serious state.
By the situation at 9:00 on May 6, the total number of hospitalized reached
May 6:
3,454 persons. Among them, 2,609 persons are in hospital for treatment,
including 471 infants. According to confirmed data, the number of radiation
disease is 367 cases, including 19 children. Among them, 34 persons are in
serious state. In the 6th Hospital in Moscow, 179 persons are in hospital,
including two infants.
During the last day, 1,821 persons were additionally hospitalized. At 10:00
May 7:
May 7, the number of persons in hospital for treatment is 4,301, including
1,351 infants. Among them, diagnosis of radiation disease was established
with 520 persons, including staffs of Ministry of Internal Affairs of the
USSR. 34 persons are in serious state.
During the last day, the number of hospitalized persons increased by 2,245,
May 8:
including 730 children. 1,131 persons left hospital. By the situation at 10:00
May 8, the total of 5,415 persons are in hospital for treatment, including
1,928 children. Diagnosis of radiation disease was confirmed with 315
persons.
remark: The total number of 40 protocols are included in the secret document.
See http://www.rri.kyoto-u.ac.jp/NSRG/reports/kr21/kr21pdf/IM-data.pdf.
The first radioactive plume released with the explosion of the reactor is considered to have
moved in a westerly direction and passed over several kilometers to the south of Pripyat
city where about 50,000 NPP workers and their families were living. On the second day
(April 27) the main direction of the radioactive plume changed to the north-west and the
north. On the third day (April 28) the main direction was considered to be northerly. Then
the direction of the radioactive plume changed to the east (April 29) and the south (April 30
and May 1).(9)
Figure 2 shows Pu contamination in the Ukrainian territory.(10) The most
contaminated areas are found to be to the west and to the north of the Chernobyl site.
Considering both the trend of daily release in Fig. 1 and the direction changes of the
radioactive plume, we can suppose that the most serious contamination in the 30-km zone
was formed during the first three days after the accident.
Evacuation from the 30 km zone
Although most people in Pripyat city knew of the accident on the first day (April 26), many
of them spent that day as a usual Saturday. It was around noon of the second day (April 27)
that the order of evacuation was announced with instructions to bring passports and food
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for three days. Evacuation of Pripyat city began at 14:00 on April 27th, about 36 hours after
the accident. Three hours later Pripyat city became an empty town. (11)
The decision to evacuate the people in other villages and towns within the 30 km zone
was made on the seventh day (May 2nd). Evacuation of rural villages, together with their
livestock, began on May 3rd. This was a very difficult task and ended on May 14th . In total
116,000 people were evacuated from the 30 km zone around the Chernobyl NPP; 90,000
from the Ukrainian territory, including 45,000 from Pripyat city, and 26,000 from the
Belarusian territory.(11,12)
Fig. 1. Daily release rate to the atmosphere of radioactive materials during the Chernobyl
accident, excluding noble gases. (3) The values are decay-corrected to May 6, 1986
and are uncertain by ± 50 %.
Radiation situation in villages within the 30 km
The detailed radiation situation within the 30 km zone on May 1, 1986 is shown in Fig. 3.
This data was published in an EC-Ukraine, Belarus and Russia collaboration report(13)
prepared for an international conference held in 1996 in Minsk. The strongest level of 3,306
μGy h-1 was observed in Krasnoe village about 6 km to the north of the NPP. The second
strongest level of 3,045 μGy h-1 was in the villages of Yanov and Usov. A generally high
level of radiation was recorded on the northern side of the 30 km zone. Comparing the
contamination pattern of Pu in Fig. 2, it is somewhat strange to note that the high level of
radiation was not recorded in villages to the west, over which we can suppose the first
radioactive plume passed. To our regret, the radiation situation data, as in Fig. 3, was
provided only for May 1st and not provided for other days after the accident.
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Fig. 2.
238+239+240
Pu contamination map of the adjacent territory to the Chernobyl NPP
(Ukrainian part). (10)
Other interesting data concerning the radiation situation in the 30-km zone was also found
in Ref 13. Diamond symbols in Fig. 4 indicate dose-rate change measured in the Khoiniki
district by the Belarusian Civil Defense team, the data of which was normalized to unit
137
Cs deposition. Two curves are calculated by the present author, assuming two kinds of
radionuclide composition deposited on the ground. (14,15) The composition for the solid line
is based on the data reported by Izrael et al,(16) while the dotted line was calculated by
reducing the ratios for 95Zr and 140Ba so as to fit the measured trend. We can say from Fig.
4 that calculation 2 can reconstruct well the temporal change of the radiation situation
during the early period after the Chernobyl accident. We can suppose, therefore, that the
dose rate on April 27th was about two times larger than that on May 1st.
Incidentally, when the present author visited Krasnoe village in November 2005, the
radiation level there was about 2 μGy h-1, which is 1,500 times less than the value shown in
Fig. 3.
External dose estimation by Imanaka
In order to clarify the possibility that the people living within the 30-km zone received a
radiation dose that could cause ARS, external doses for evacuees from several villages were
estimated based on the above-mentioned data and the following three assumptions:
• Radioactivity deposition occurred at 12:00 on April 27, 1986.
• The dotted line in Fig. 4 can be applied to every village to reconstruct the temporal
change of dose rate in air before evacuation.
• A log-normal type of individual dose distribution can be applicable within a
village.
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Fig. 3. Dose rate in the air at settlements within the 30-km zone around the Chernobyl site
on May 1, 1986, unit: μGy/h. (13) Names of settlements were added by the present
author.
The average dose for each village was calculated by integrating dose rate from 12:00 on
April 27 to 12:00 on the day of evacuation. The results of external dose estimation are
summarized in Table 2. The detailed procedure used to get values in Table 2 is described in
Refs. 14 and 15. The fractions of population whose dose were estimated to be over 500 and
1,000 mSv were calculated in each village based on a log-normal distribution with a
geometric SD value of 100.277 that was obtained from the data in Ref. 13. The criteria of 500
mSv was chosen as a dose level over which clinically significant depression appears in the
blood-forming function.(17) According to Ref. 12, there were 159 inhabitants in Usov
village at the time of the accident, which means that 32 and 4 persons could receive more
than 500 and 1,000 mSv, respectively. Although the size of the population of Krasnoe
village is unclear, judging from the size of the village, its population should be several
times larger than Usov. Our results of external dose estimation, therefore, indicate that a
substantial number of evacuees received an external dose of more than 500 or 1,000 mSv,
which could cause ARS.
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Fig. 4. Dose rate change in the Khoiniki district in the first month after the accident
normalized per unit deposition of 137Cs. (14)
Table 2. Estimates of external dose at several settlements in the 30-km zone until
evacuation.
Date of
Settlement
Dose rate
Total external
Fraction
Fraction
on May 1, evacuation
dose before
exceeding 500 exceeding
*
evacuation, mSv
mSv, %
1,000
mGy⋅h-1
mSv, %
Krasnoe
3.306
(May 3)
0.32
24
3.5
Usov
3.045
May 3
0.29
20
2.6
Borshchevka
0.870
(May 5)
0.10
0.5
∼0
Chernobyl
0.174
May 5
0.02
∼0
∼0
* Date of evacuation was obtained from Likhtarev et al.(12) were assumed from dates of
close-by settlements.
Dose estimation of Chernobyl Forum
The conclusion of the Chernobyl Forum that the average external dose was 20 mSv for
evacuees from the Ukrainian part of the 30-km zone is largely based on the work by
Likhtarev et al.(12) Using questionnaires regarding the daily behavior of 36,000 evacuees,
they reconstructed the individual external dose of about 31,000 evacuees from the 30-km
zone, including about 14,000 from Pripyat city. The average external doses of the evacuees
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were evaluated to be 11.5 and 18.2 mSv for Pripyat city and other villages in the 30-km
zone, respectively. The maximum external dose among all evacuees was estimated to be
381 mSv. If we accept these estimates, it is difficult to doubt the occurrence of ARS among
inhabitants around the Chernobyl NPP.
The average external dose for evacuees from Usov village was estimated both by
Likhtarev et al. (118 mSv) and by the present author (320 mSv). Our estimate is three times
larger than Likhtarev et al. Although the reason of the three-fold difference is unclear,
several points should be mentioned regarding the work by Likhtarev et al. At first, they
excluded about 4,000 persons from their dose reconstruction study, the reason being that
these people had stayed in highly contaminated areas or visited the Chernobyl station.
Secondly, their average estimate of 18.2 mSv for evacuees from other villages was only
1.5 times larger than that for evacuees from Pripyat city. This ratio seems to be too small
considering that the people in Pripyat city evacuated on the second day, while the people in
other villages stayed more than a week before evacuation. From the data in the 1986 USSR
report (3) the average external doses of 160 and 33 mSv were estimated, respectively, for
evacuees from other villages and those from Pripyat city.
Thirdly, although the detailed data of the radiation situation used to estimate external
dose in Pripyat city was presented in their paper, no concrete radiation data were shown
that were used for other villages. Interesting data is shown in the paper by Muck et al.(18)
regarding inhalation dose estimation in the 30-km zone, of which Likhtarev is one of coauthors. They plotted temporal changes of dose rate observed during the three weeks
following the accident in 49 settlements within the 30-km zone. Considering radioactivity
release patterns described in this article so far, temporal changes of dose rate in Muck’s
paper are very difficult to understand. For example: the maximum dose rate in Yanov
village was recorded May 2nd (the seventh day) and that of Krasnoe was May 1st (the sixth
day). In all villages dose rates in the first three days (April 26 – 28) were much lower than
the later period.
If the dose rate data in Muck’s paper were also used in the previous work to estimate
external doses, we should consider the possibility that the external dose values in Ref. 12
are underestimated to a large extent, as well as the conclusion of the Chernobyl Forum
report.
Conclusion
In order to consider the possibility that ARS occurred among inhabitants around the
Chernobyl NPP, external dose was estimated for the evacuees from several highly
contaminated villages, using published data of the radiation situation together with several
assumptions. Our findings are summarized as follows;
• The average external dose for evacuees from settlements in the 30-km zone did not
reach the 500 or 1,000 mSv, criteria for ARS.
• Taking into consideration the distribution of individual doses within a village,
substantial numbers (20 to 24 %) of inhabitants in highly contaminated villages
could have received external doses exceeding 500 mSv. Some of them could have
received more than 1,000 mSv.
• Our results are consistent with the information given in several publications that
there were a substantial number of ARS cases among inhabitants around
Chernobyl.
• Our estimates are roughly 3 times larger than those made by Likhtarev et al.,
which is considered to be the basis upon which the conclusion of the Chernobyl
Forum report was made: that no ARS occurred among inhabitants.
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Although internal dose has not been discussed in this article, one comment should be
added. According to the Chernobyl Forum report, the average internal dose of Ukrainian
evacuees is concluded to be 10 mSv, excluding 300 mSv of thyroid organ dose. Prohl et al.
tried to reconstruct the ingestion dose of evacuees from the 30-km zone.(19) They estimated
the range of total effective dose by inhalation and ingestion to be 35 – 1,600 mSv for
infants and 15 – 440 mSv for adults, more than 50 % of which came from the thyroid dose.
These figures clearly indicate that internal dose, which has not been discussed in the present
article, contributed significantly to the total dose.
This April, twenty years will have passed since the Chernobyl accident. It must be
emphasized, however, that there is still a large contradiction regarding the estimates of
radiation dose that the inhabitants living around the Chernobyl NPP received immediately
after the accident, as well as contradictions regarding ARS cases among them. Further
efforts are needed to resolve these contradictions.
References
1. The Chernobyl Forum; Chernobyl’s Legacy: Health, Environmental and Socio-economic
Impacts and Recommendations to the Government of Belarus, the Russian
Federation and Ukraine. IAEA, September 2005.
2. USSR State Commission on the Utilization of Atomic Energy; The Accident at the
Chernobyl Nuclear Power Plant and Its Consequences. August 1986.
3. IAEA; One Decade after Chernobyl: Summing Up the Consequences of the Accident.
Proceedings of an International Conference, Vienna, 8-12 April 1996,
STI/PUB/1001, IAEA, 1996.
4. UNSCEAR; Source and Effects of Ionizing Radiation, UNSCEAR 2000 Report, Annex
J. United Nations, 2000.
5. A. Yaroshinskaya; Chernobyl: Top Secret. Drugie-berega, Moscow, 1992 (in Russian).
6. A. Yaroshinskaya; Impact of Radiation on the Population during the First Weeks and
Months after the Chernobyl Accident and Health State of the Population 10
Years Later. In: Imanaka T. ed.; Research Activities about the Radiological
Consequences of the Chernobyl NPS Accident and Social Activities to Assist
the Sufferers by the Accident Chernobyl. KURRI-KR-21 (http://www.rri.kyotou.ac.jp/NSRG/reports/kr21/KURRI-KR-21.htm), 104-107, 1998.
7. V. Lupandin; Invisible Victims. NABAT No. 36, Minsk, October 1992 (in Russian).
8. V. Lupandin; Chernobyl 1996: New Materials concerning Acute Radiation Syndrome
around Chernobyl. KURRI-KR-21, 108-113, 1998.
9. Yu. A. Izrael, Chernobyl: Radioactive Contamination in the Environment,
Gidrometizdat, 1990 (in Russian).
10. A. Gaydar and O. Nasvit; Analysis of Radioactive Contamination in the Near Zone of
Chornobyl NPP. In: Recent Research Activities about the Chernobyl NPP
Accident in Belarus, Ukraine and Russia. KURRI-KR-79 (http://www.rri.kyotou.ac.jp/NSRG/reports/kr79/KURRI-KR-79.htm) 59-73, 2002.
11. International Advisory Committee; The International Chernobyl Report: Technical
Report. IAEA, 1991.
12. I. A. Likhtalev et al.; Retrospective Reconstruction of Individual and Collective
External Gamma Doses of Population Evacuated after the Chernobyl Accident.
Health Physics, 66(6): 643-652 (1994).
13. I. K. Baliff and V. Stepanenko ed.; Retrospective Dosimetry and Dose Reconstruction.
Experimental Collaboration Project No.10, EUR 16540, EC, 1996.
14. T. Imanaka and H. Koide; Dose Assessment for Inhabitants Evacuated from the 30-km
Zone Soon after the Chernobyl Accident. KURRI-KR-21, 121-126, 1998.
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15. T. Imanaka and H. Koide; Assessment of External Dose to Inhabitants Evacuated from
the 30-km Zone soon after the Chernobyl Accident. Radiation Biology
Radioecology, 40: 582-588 (2000).
16. Yu.A.Izrael et al.; Radioactive Contamination in the Environment of the Zone around
the Chernobyl Atomic Station, Meteorology and Hydrology, 1987 No.2, pp.5-18
(in Russian).
17. 1990 Recommendations of ICRP, ICRP Publication 60, Annals of the ICRP, 21 1991.
18. K. Muck et al.; Reconstruction of the Inhalation Dose in the 30-km Zone after the
Chernobyl Accident. Health Physics, 82(2):157-172 (2002).
19. G. Prohl et. al.; Reconstruction of the Ingestion Doses Received by the Population
Evacuated from the Settlements in the 30-km Zone around the Chernobyl
Reactor. Health Physics, 82(2):173-181 (2002).
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CHAPTER 11
Combined Spatial-Temporal Analysis of Malformation Rates in Bavaria After
the Chernobyl Accident
Helmut Küchenhoff, Astrid Engelhardt, Alfred Körblein
Malformation rates in the German state of Bavaria, as a whole, did not increase in 1987, the
year following the Chernobyl accident. Also an analysis of the monthly data does not show
any association between radiation exposure and malformation rates seven months later. But
in a detailed analysis on the level of districts, taking the spatial structure into account, we
find an association between malformation rates and the calculated caesium concentration in
pregnant women. We used a non-parametric estimation of the dose-response relationship,
which gives an increasing malformation risk for regions with higher caesium exposure. The
results should be interpreted carefully since the analysis has been conducted as an
explorative observational study. The results are not in line with the present understanding
of the biological effects, including the existence of a threshold dose, for teratogenic effects
of low level ionising radiation.
Background
Ionising radiation is an established risk factor for congenital malformations making them an
relevant endpoint in the study of possible health effects from the Chernobyl accident. An
increased prevalence of congenital malformations at birth was reported for different
European countries after the Chernobyl accident. However, existing databases often do not
meet quality criteria required for meaningful epidemiologic analysis. The EUROCAT
registry only covers approximately 10% of the European population. Also, underascertainment of prevalent cases is a systematic problem in many registers.
An overview of the literature on malformation rates following Chernobyl is given
in a review article by Hoffmann [1]. In northern Turkey, a significant increase of neural
tube defects was reported. A rise in congenital malformations after Chernobyl was found in
Belarus. In Croatia, an increase of CNS anomalies was detected in aborted foetuses or in
newborns that died within 28 days of delivery. The EUROCAT registry, however, revealed
no indication of a systematic increase in the prevalence of Down’s syndrome, anencephaly,
or spina bifida. Most researchers argued that the radiation exposure from the Chernobyl
fallout would be too low to cause any measurable increase in malformation rates.
In Germany, data of the prevalence of malformations at birth were collected a posteriori in
the State of Bavaria, several years before and after Chernobyl (1984 to 1991). Bavaria was
the German Federal state with the highest radiation exposure from Chernobyl. A study,
conducted by the German Federal Office of Radiation Protection (Bundesamt für
Strahlenschutz, BfS), found no significant difference in malformation rates between the
higher exposed southern part of Bavaria and the less contaminated northern part following
Chernobyl [2].
In a study on perinatal mortality in Germany following the Chernobyl accident,
Körblein and Küchenhoff found a small but statistically significant mortality rise in 1987,
the year after the Chernobyl accident. Furthermore, an analysis of the monthly data gave an
association between caesium burden and perinatal mortality seven months later [3]. There
would have been a similar possible effect on congenital malformations as experimental
studies on mice have shown that irradiation of the foetus with 200 R during the period of
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major organogenesis (day 6 to 13 post conception) resulted in 100% malformed offspring
and, to a lesser degree, neonatal deaths [4].
In our study we performed a trend analysis with the same model as in [3]. Then we used
ideas of the analysis in [2], in which a comparison of regions was conducted.
Figure 1: Development of caesium concentration in pregnant women following the
Chernobyl accident. The light columns are the contributions from milk, the dark columns
the additional contributions from beef, pork and cereals.
caesium concentration [Bq/kg]
50
40
30
20
10
0
86
87
88
calendar years
Data
Out of a total of 29,961 newborn with malformations only 7,171 cases were considered
appropriate for evaluation; the others were excluded for different reasons by the German
Federal Office of Radiation Protection (Bundesamt für Strahlenschutz, BfS). Each case was
recorded with diagnosis, sex, date of birth and residence of the mother. This data set was
provided by BfS for evaluation.
Data for the caesium-137 soil contamination on a district level (96 districts) were
also obtained from BfS. Daily measurements of the caesium concentration in cows milk in
Munich from May 1986 until the end of 1988 were provided by the state supported Society
for Environment and Health (Gesellschaft für Umwelt und Gesundheit, GSF).
Monthly values of the caesium concentration of pregnant women, were calculated on the
basis of 4 main food components (milk, beef, pork, cereals) and average consumption rates.
They are displayed in Figure 1. There is a first peak in the caesium burden in June/July
1986, and a second in April/May 1987. During the winter 1986/87 cows were fed
contaminated grass harvested in summer 1986. Therefore the caesium concentration in
pregnant women shows a second increase in the winter season 1986/87.
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Figure 2: Estimated effect of the caesium term (CS7) on malformation rates, Bayes' model.
The numbers on the y-axis are the logarithms of the odds ratios. The upper and lower
curves indicate the 95% confidence limits.
Methods
In a first step, the model used by Körblein and Küchenhoff in [2] is applied to fit the
monthly malformation rates in Bavaria:
P (Y = 1) = α + exp( β 0 + β1t ) + β 2 (cs(t − 7))
In a second step, a combined spatial-temporal analysis is conducted. The monthly
malformation rates in all 96 Bavarian districts and in 96 months (1984-1991) are analysed
as a function of place and time.
As a proxy for the internal caesium exposure in district k at time t, a caesium term cs(k,t) is
formed which is the product of the time dependent concentration cs(t) in pregnant women
and the caesium soil contamination cs(k) in district k with k = 1, .. , 96. We use a
nonparametric logistic regression model of the following form:
P (Y (k , t ) = 1) = G (α k + f (cs(k , t − 7) + g (t ))
Here G ( z ) = 1 /(1 + exp(− z )) is the logistic function.
The probability of a malformation of child i in region k and in month t is denoted
by P(Y ( k , t ) = 1) .
The expression f(cs(k,t-7)) is a smooth function which associates the malformation rates
with the delayed caesium concentration cs(k,t-7) (time-lag 7 months). This association is
estimated by nonparametric methods. Furthermore, the spatial structure is taken into
account by assuming a random regional effect which has a correlation dependent on the
distance between the regions. The function g(t) is a flexible smooth overall trend
component.
For the calculation we use a Bayesian approach by Fahrmeir and Lang [5]. The function f
is estimated by a penalised spline approach. The calculations were performed by the
program Bayes X [6].
For a sensitivity analysis we fitted other less complicated models, including a parametric
logistic model with polynomial trend and polynomial caesium term, and a nonparametric
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logistic model with a regional effect without assuming a spatial structure. These analyses
were performed by the program package SAS. We also conducted the analyses with timelags of 6 and 8 months between exposure and delivery.
Figure 3: Estimated effect of the caesium term on malformation rates, non-parametric
model. The numbers on the y-axis are the logarithms of the odds ratios. The broken lines
indicate the 95% confidence limits.
Results
The first model does not give any significant association between caesium exposure and the
malformation rates in Bavaria as a whole.
In the second model, the dose response relationship given in Figure 2 is found.
Although formal test procedures have not been performed, the pointwise confidence limits
give a clear indication for an association between caesium exposure and malformation risk.
The result was confirmed in parametric approaches and in a nonparametric approach
without the spatial effect (see Figure 3).
Discussion
To summarise, no association between malformation rates and caesium exposure was found
in the first part of the analysis. In a second explorative analysis, using a regression model
on an area level, an association between the delayed caesium exposure in pregnant women
and malformation rates was found (time-lag 7 months). There is an apparent decrease of
risk at low values of the caesium exposure which, however, should not be over-interpreted
since the data are also compatible with a practical threshold at low doses. But the decrease
at low doses might explain the fact that no caesium effect is found in the data of Bavaria as
a whole.
In 1996, the German radiation protection commission (SSK) estimated the effective
radiation dose from Chernobyl in the highest exposed German areas near the Alps
(Voralpengebiet) as 0.65 mSv for the first follow-up year. The ICRP 90 recommendations
[7] state that the malformation risk is greatest during the period of major organogenesis (37 weeks post conception), with an estimated dose threshold of around 100 mSv foetal dose
of low-LET radiation, and that the induction of malformations at low doses may therefore
be discounted (quoted in the recent WHO report on the Health Effects of the Chernobyl
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Accident from July 26, 2005). Since the radiation exposure in Bavaria was 2 orders of
magnitude below this threshold dose, no effect on malformations should have been
expected.
Our results challenge the concept of a threshold dose of about 100 mSv for the
induction of malformations and suggest that the form of the dose response curve at very
low doses is non-monotonous. According to Burlakova [8], radiation effects are best
characterised by a bimodal dose response curve with a low dose maximum, followed by a
plateau region or even a decrease, and a subsequent increase at higher doses. The proposed
mechanism involves an increase of DNA repair efficiency by low level radiation exceeding
a certain trigger dose.
In conclusion, we believe that the biological effects of very low dose ionising
radiation, as yet, are not well understood and deserve further attention.
References
1.
Hoffmann W. Fallout from the Chernobyl nuclear disaster and congenital
malformations in Europe. Arch Environ Health. 2001 Nov-Dec;56(6):478-84.
2.
Irl C, Schoetzau A, van Santen F, Grosche B. Birth prevalence of congenital
malformations in Bavaria, Germany, after the Chernobyl accident. Eur J Epidemiol.
1995 Dec;11(6):621-5.
3.
Körblein A, Küchenhoff H. Perinatal mortality in Germany following the Chernobyl
accident. Radiat Environ Biophys. 1997 Feb;36(1):3-7.
4.
Russell LB, Russell WL. An analysis of the changing radiation response of the
developing mouse embryo. J Cell Physiol. 1954 May;43(Suppl. 1):103-49.
5.
Fahrmeir L, Lang S. (2001): Bayesian Inference for Generalized Additive Mixed
Models Based on Markov Random Field Priors. Journal of the Royal Statistical
Society C, 50: 201-220.
6.
Brezger A, Kneib T, Lang S. (2005): Bayes X: Analysing Bayesian structured
additive regression models. Journal of statistical software 14 (11).
7.
ICRP (2003) International Commission on Radiological Protection. Biological
effects after prenatal irradiation (embryo and fetus), Publication 90. Annals of the
ICRP 23.
8.
Burlakova EB, Goloshchapov AN, Gorbunova NV, Gurevich SM, Zhizhina GP,
Kozachenko AI, Konradov AA, Korman DB, Molochkina EM, Nagler LG, Ozerova
IB, Skalatskaia SI, Smotriaeva MA, Tarasenko OA, Treshchenkova IuA,
Shevchenko VA. [The characteristics of the biological action of low doses of
irradiation]. Radiats Biol Radioecol. 1996 Jul-Aug;36(4): 610-31. [Article in
Russian].
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CHAPTER 12
Radio-Ecological Consequences in Belarus 20 Years After the Chernobyl
Catastrophe and the Necessity of Long-Term Radiation Protection for the
Population.
Professor V.B. Nesterenko, expert-ecologist A.V. Nesterenko
Institute of Radiation Safety Belrad
1. Analysis of the implementation of short-term radiation protection measures for the
Belarusian population
On April 28 and 29, 1986 the Institute of Nuclear Energy of the Academy of Sciences of
BSSR (INE) submitted proposals on the implementation of iodine prophylactic measures
for the population and on re-settlement of the whole population living within 100-km of the
NPP.
In April 1986 our proposals were not accepted and it was not until the beginning
of May that the government decided to implement iodine prophylactic measures and to resettle people from a 30-kilometer zone surrounding the NPP. That May several hundred
children were brought to clean regions of Russia.
Following a decision by the government of Belarus, a scientific and technical
commission was organized at the beginning of May. It consisted of an academic N.A.
Borisevich, the President of the Academy of Sciences, Professor I.N. Nikitchenko,
Professor V.B. Nesterenko, Professor Ye.P. Petryayev, Professor S.S. Shushkevich and
Professor Ye.F. Konoplya.
On May 3, 1986 I visited the Chernobyl regions of Belarus along with a group of
specialists from the radiation safety service of INE. Subsequently, another letter (dated May
7) was sent to the government with proposals to re-settle the population living within the
100-km zone from the NPP, as well as proposals concerning other radiation protection
measures.
At the end of May 1986, the first map of Caesium-137 deposition in the Gomel
region (fig.1) was drawn up at the Institute. Following the presentation of this data, the
population of the southern regions of Belarus (50 to 70-km zone from NPP) was also resettled, between June 5th and June 10th, 1986.
During the first months after the accident, after making a decision to re-settle inhabitants
from affected districts, the local authorities began to implement the following principles;
not to allow working resources {sic} to leave their district and to encourage the building of
new habitations in these districts. One good example of such a mistake is the decision made
by the Mogilyov Regional Committee of the Party and the Regional Executive Committee
to build the settlement Maysky in the Cherikov district and to re-settle there the inhabitants
from settlements Chudyany and Malinovka of the same district. As a result, the inhabitants
of the new settlement raised agricultural products on their former individual plots (3 to 5
km from the new settlement Maysky) with a contamination density over 40 to 80 Ci/km2
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Fig. 1. Caesium 137 deposition in the Gomel region (see text).
.
On June 22, 1986 INE submitted the map of Caesium-137 deposition in the Mogilyov
region to The Ministry for Public Health Services (MPHS), The Ministry for Agricultural
Production (MAP) and to The Mogilyov regional executive committee. As there was no
reaction N.A. Borisevich, V.B. Nesterenko and the chairman of the Committee for
Hydrometeorology submitted the map to the government and to the Central Committee of
the Communist Party of Belarus, proposing that the MPHS investigate fully the possible
dangers of living within the 50 settlements of the Mogilyov region. Our proposals were not
accepted and no concrete decisions were made, but in September our Institute was visited
by the party committee in order to divert the staff of the Institute from activities connected
with the Chernobyl subject and to “prove” the effectiveness of their inadequate measures
for radiation protection of the population.
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In September 1986, by approbation of the authorities of the Academy of Sciences
and the government of Belarus, INE submitted a map of radiation deposition in the southern
regions of the Republic which included Caesium-137 as well as other radioisotope
depositions.
Local foodstuffs were transported from all southern regions of Belarus to the
Institute for radiation monitoring. At that time the measurements of radionuclide
concentrations in foodstuffs were made at INE, the Institute of Physics of the Academy of
Sciences and at The Department for Nuclear Physics of the Byelorussian State University.
In the summer of 1986, with the participation of the agrochemical services of the MAP of
Belarus, soil samples were taken in all southern regions of Belarus and, in SeptemberOctober, maps were produced of radiation deposition on agricultural holdings in the
southern regions of Belarus (districts and farms).
The population of Belarus that lived in the areas contaminated by Caesium-137
over 37 kBq/m2 consisted of 2,105,200 persons (including over 500 thousand children). To
a greater degree a quarter of the territory and one fifth of the population of the republic
were affected.
Today the Chernobyl regions of Belarus are characterised by a distorted
demographic structure. During the years following the catastrophe 135,000 people were resettled and not less than 200,000 persons became enforced refugees or left the contaminated
district on their own. The first to leave were the young people, intellectuals, skilled
specialists and officials. In some affected districts pensioners were to make up about 70%
of the population.
Radioactive contamination of the territory caused serious problems in agriculture,
especially radiation contamination of agricultural production and local foodstuffs produced
on those lands. About 20% (1.6 million hectares) of all agricultural holdings were exposed
to 137Cs-contamination over 1 Ci/km2, largely in traditional agricultural districts. From 1986
to 1990 257,100 hectares of agricultural holdings were excluded from agricultural
circulation.
Many errors were made in Belarus during the implementation of activities on
contaminated territories, including the lack of effective protective measures for the
population. These errors were the result of misguidance by the Joint Government from
Moscow and the Byelorussian authorities acting according to the orders of the
Governmental Commission on Chernobyl located in Moscow. The Moscow bureaucracy
were busy portraying a false picture regarding the safety of living in contaminated regions
in order to show the whole world that the dimensions of the damage to Belarus were not
significant.
The following are examples of the negligence that ensued; On June 13, 1986 L.N.
Kuznetsov, the chairman of the State Committee for Agricultural Production
(Gosagroprom) of the USSR , in coordination with P.N. Burgasov, the Chief State
Physician of the USSR, accepted “Temporary Recommendations for the Conduct of
Agricultural Production in the Byelorussian SSR on Radio-contaminated Territories”. This
permitted the production of agricultural products even on lands within the 3rd zone where
the dose rate was between 5 microroentgens to 20 microroentgens an hour and to distribute
them over the whole Republic. The local population living in that area throughout the year
accumulated high amounts of radionuclides due to the local dependence on these radiocontaminated foodstuffs.
“Recommendations for the Use of Meat Containing Radioactive Substances
2.0*10-7 to 1.0*10-6 Ci/kg for Production of Cooked Meats for 1986” accepted by the
same L.N. Kuznetsov and coordinated with A.I. Zaichenko, the deputy Chief State
Physician, were so cruel and cynical. Permissible Caesium-137 concentration levels in
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sausages were achieved by mixing clean meat with radioactively contaminated meat
containing a Caesium-137 concentration between 18,000 and 37,000 Bq/kg.
On June 24, 1986 the same men accepted the “Temporary Recommendations for
the Primary Processing of Wool Received from Radio-contaminated Animals”. The only
factory for the primary processing of wool in the whole republic of Belarus was located in
Zhuravichi in the Gomel region; therefore, after simultaneously processing “clean” and
“contaminated” wool at that enterprise, all wool eventually became radioactive. It was then
used for making clothing, which additionally increased the external dose of the population.
On July 23, 1986 G.A. Romanenko, the deputy Chairman of Gosagroprom of the
USSR in coordination with A.I. Zaichenko, the Deputy Chief State Physician, accepted the
“Temporary Recommendations for Procedure of Purchase, Acceptance, Storage and Use of
Grains and Grassy Meal of the Crop 1986 Gathered on the Territory of the RSFSR, the
Ukrainian SSR and Byelorussian SSR Exposed to Radiation Contamination”. It was
recommended to continue grain production, to continue to feed cattle with the radioactive
grain and to continue to use the grain to make alcohol; hence the Caesium-137
contamination of milk and meat, and finally – people.
On the basis of those recommendations Gosagroprom of the BSSR, in association
with The Ministry for Grain Production of the BSSR, repeated those instructions in their
order No. 3c/21 C dated June 27, 1987. In order to carry out these instructions about 1
million tonnes of radioactive grains were processed and fed at poultry-farms and hogbreeding farms. At the same time two Ministries approved the list of 17 districts of Gomel
and Mogilyov regions. This grain should have been exposed to continuous dosimetric
control as possible Caesium-137 concentration levels in the grain were 3,700 to 370 Bq/kg.
On July 01, 1987, there was an order by the government of the USSR. This was
based on the conclusions of the MPHS of the USSR that it was possible to set a dose limit
for the population living on contaminated territories of about 50 rem over 70 years. This
was allocated as follows: during the first 10 – 25 years the distribution of the annual doses
would be 3; 3; 2.5; 2; 2; 1.5; 1.5; 1; 1; 1 and then 0.5 rem each year up to the 70th year after
the accident. In the report on the radiation situation in Mogilyov, Gomel, Bryansk and Kiev
regions the Committee for Hydrometeorology of the USSR, MPHS of the USSR, the
Council of Ministers of Belarus, the Ukraine and Russia concluded the following – It is
possible for the population to continue to live in districts with territorial contamination over
40 Ci/km2 while using imported foodstuffs (especially milk) through implementing the
following precautionary activities:
♦
“decontamination in settlements contaminated over 40 Ci/km2” (soil layer removal,
making firm covers, changing thatches etc.) and the simultaneous ploughing up and
sowing of perennial grasses and crops in the fields surrounding these settlements:
settlements contaminated over 60 Ci/km2, to be addressed during 1987, the rest - in
1988);
♦
“Implementation of the whole complex ..... of special soil-conservation activities on all
croplands in 1987 and on all pastures in the zone about 40 Ci/km2 in 1987 and 1988.
Separation of plots (in autumn 1987) for the urgent grassing for pastures for depasturing cows belonging to the population in settlements contaminated over 40
Ci/km2 to the cost of croplands (with their exclusion out of land tenure)”;
♦
“completing the recommended soil-conservation activities in 1987 on the territories of
private farms contaminated under 40 Ci/km2 and implementation of intensive soilconservation activities (with the application about 20 tonnes of zeolites per hectare and
increased quantities of fertilisers) in settlements contaminated over 40 Ci/km2”;
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♦
“implementation of a complex of activities on agricultural holdings contaminated by
about 80 Ci/km2 will lead to a decrease in the contamination of agricultural products by
1987 and 1988, and in a further 3 to 4 years the pollution of all foodstuffs is expected
to decrease to the level of the established norms, leading to a cancellation on all
restrictions in the use of private agricultural products from private plots (within the
first 10 years)”.
In March 1988 the chairman of Gosagroprom of the USSR, V. Murakhovsky approved the
“Guide for Conducting Agriculture in Conditions of Radioactive Contamination of the Part
of the Territory of the RSFSR, the Ukrainian SSR and Byelorussian SSR for 1988 to 1990”
submitted by the Inter-departmental commission of scientific experts in radiology and
agriculture, concerning peculiarities in the production of agriculture on radio-contaminated
territories from 1.5 to 40 Ci/km2.
This guide suggested an application of a 1.5 increased dose of phosphoric and
potassium fertilisers on hayfields and pastures annually; the continuation of cattle-breeding;
the application of 2 to 3 kg of double super-phosphate and 3 to 4 kg of potassium chloride
and sulphate per 100 m2, lime materials and zeolite (200 kg per 100 m2) in order to reduce
radionuclide entry in fruits, vegetables and potatoes in vegetable gardens.
The use of local fodder for poultry is not limited - provided they are fattened with
clean or only slightly contaminated fodder 1 - 1.5 months before slaughter; there are no
restrictions on cattle-breeding and pig-breeding and their fattening, but 1.5 or 2 months
before their expected slaughter the cattle should be kept indoors and fattened with clean
fodder. As is evident from the guide, the specialists of the Union bodies required a
continuation of production on contaminated territories, by any means, in spite of the fact
that fattening with contaminated fodder caused the contamination of all kinds of products.
Following the instructions made by the Gomel Agricultural Committee, from 1987
to 1990 the officials of enterprises sent people to the re-settlement zone where grass and
grains were sown to be used for feeding cattle.
In September 1989 a group of 92 scientists (incl. 5 Byelorussians) joined that
dangerous game connected with the concept of safely living in radio-contaminated
territories. They petitioned M.S. Gorbachyov. In that petition they contended that the dose
of 35 rem for a life-time, accepted by the National Committee for Radiation Protection
(NCRP) of the USSR, was based on the long-term examination of the state of health of the
population in Hiroshima and Nagasaki, as well as in the Chelyabinsk district of Russia
affected by the accident resulting from the storage of radioactive waste in 1957. In their
petition the authors insisted that re-settlement of the inhabitants from the settlement should
take place and that they could resume normal living conditions without any restrictions,
even if the dose there exceeded the 35 rem life-time dose. Those proposals were approved
by IAEA, WHO, NCARE and the UN.
That was in 1989. The scientists both in Belarus and in the Ukraine were not in
agreement with the “35 rem during a life-time” concept of the NCRP of the USSR –. The
Academy of Sciences of Belarus put forward a new recommendation for living on
contaminated territories – 7 rem during a life-time.
MPHS of the USSR (A.Kondrusev) and NCRP of the USSR (L.A. Ilyin) organised
a visit of representatives from the International Committee for Radiation Protection and
WHO to Belarus. On June 24, 1989, at a meeting in the Academy of Sciences, we were
persuaded to accept the “35 rem during a lifetime” concept and, during my report, Dr.
Pelleren declared that we should accept 70 and 100 rem during a lifetime because of the
lack of financing for providing the population with clean foodstuffs and radiation
protection.
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The new concept of living on territories contaminated after the Chernobyl accident
suggested that the permissible limit of 0.1 rem (1 mSv) a year should be accepted, along
with their step-by-step goal: in 1991 – 0.5 rem (5 mSv)/a; in 1993 – 0.3 rem (3 mSv)/a; in
1995 – 0.2 rem (2 mSv)/a; in 1998 – 0.1 rem (1 mSv)/a.
The new zonation was accepted:
Zone of obligatory re-settlement: Caesium-137 – 40 Ci/km2, Strontium-90 – 3 Ci/km2,
Plutonium – 0.1 Ci/km2,
Zone of re-settlement: Caesium-137 – 15 to 40 Ci/km2, Strontium-90 – 2 to 3 Ci/km2,
Plutonium – 0.05-0.1 Ci/km2, when the annual dose can exceed 5 mSv/a.
But now over 28 thousand persons live in this zone {sic}, including 7,000 children. In the
Ukraine all people were re-settled from the zone of 15 Ci/km2.
Zone with the right for re-settlement: Caesium-137 5 to 15 Ci/km2, Strontium-90 – 0.5 to 2
Ci/km2, Plutonium – 0.01 to 0.05 Ci/km2, when the permissible radiation limit for the
population exceed 1 mSv/a.
Zone of living with periodical monitoring: Caesium-137 1 to 5 Ci/km2, when the
permissible radiation limit for the population must not exceed 1 mSv/a.
2. Organisation of radiation monitoring of agricultural holdings and foodstuffs
In the summer of 1986 the staff of INE and MAP (2 persons from each organisation)
selected soil samples from all kinds of agricultural holdings (5 samples from every 100
hectares) and individual plots. The samples with distinct selective coordinates were brought
to INE where they were tested on the γ-spectrometer. By July 15, 1986 over 10,000 samples
were brought in. Maps of Caesium-137 deposition on agricultural holdings on farms,
districts and regions were made according to the results of their tests. Radiochemical
measurements of the samples for Strontium-90 concentration were conducted.
Following the first months after the accident at the Chernobyl NPP the control of
foodstuffs from contaminated zones was conducted at three Institutes.
By the middle of July 1986 mobile radiological laboratories were created at
Gosagroprom and MPHS of Belarus. Radiometers for controlling foodstuffs were produced
at the Institute for Nuclear Energy, the Byelorussian State University and the Institute of
Physics and distributed to the radiological services and Institutes of the Ministry for
Agricultural Production of the republic. The mobile laboratories, with specialists from
MPHS and Gosagroprom, visited all the farms in the Gomel and Mogilyov regions and
stated that the majority of plants, fodder and products of animal husbandry were
contaminated by Caesium-137 and Strontium-90. Unfortunately, without knowing the
actual size of the accident, the authorities in the republican departments and in the regions
ordered the production of contaminated products everywhere, based on the Union
recommendations. Therefore, radiation control services were organised at all 27 enterprises
of the meat industry, 127 dairy enterprises, 114 enterprises of the food industry, 61
enterprises of the Ministry of Grain Production, 56 enterprises of the fruit and vegetable
industry and also in 1,200 collective and state farms whose territories had been
contaminated by radionuclides. Apart from that, 12 agricultural research institutes, 3
republican, 6 regional, 117 local vet bacteriological laboratories, 188 stations for testing
meat, 117 inter-regional laboratories, 6 regional stations for chemisation {sic}, 10 pedigree
enterprises and 78 poultry-farms were used as places for the implementation of radiation
monitoring. The whole radiation monitoring system included 2,122 places.
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During these first months, the funds for equipping the laboratories were provided
by the departments of the institutes in Minsk, and included the output of several hundreds
of radiometers KRVP-3AB from the Lenin Minsk industrial works, which had produced
them for equipping atomic submarines. According to our request, a large shipment of
radiometric devices SRP-68-01 (about 4,000) was delivered from U-mines and atomic
enterprises in Siberia. Radiometers KRP-1, KRVP-3AB, RKP-4SM, SRP-68-01, RUPP,
RIS-1 were assembled and produced. In order to equip all centres by the middle of June
1986 the following quantities were necessary: 502 radiometers DP-100, 639 – SRP-68-01
and approximately 300 KRVP devices. By the beginning of June there were only 121 DP100 and 37 SRP-68-01. By January 01, 1987 there were 189 DP-100, 57 KRVP-3AB, and
799 SRP-68-01.
By October 1986 we prepared 3,077 specialists from the Byelorussian State
University and the Academy of Sciences of the Republic for work at the centres for
radiation control.
In August 1986 the system of radiation monitoring of foodstuffs at Minsk markets
was approved.
In August 1987 the system of radiation monitoring of foodstuffs, agricultural
products and the environment of Belarus was approved. Apart from agricultural products, it
monitored the contamination of mushrooms, wild berries and herbs.
All maps and findings on radiation contamination levels in foodstuffs were
classified as secret. In spring 1989, at the 1st session of the Supreme Soviet of the USSR,
due to the initiative of the deputies from Belarus, the Ukraine and A.D. Sakharov, it was
decided to remove all details connected with the Chernobyl catastrophe from the secrets
list.
Following the removal of the material connected with Chernobyl from the secrets
list and following the actions of the state bodies for radiation protection of the population,
the inhabitants of Belarus (as well as in the Ukraine and in Russia) began to mistrust all
information regarding the size of the accident, the contamination degree of local foodstuffs
and the health effects submitted by the state bodies.
Even at that time, the main danger for the population came from the consumption
of radio-contaminated foodstuffs. That danger - of constant radionuclide accumulation in
the inhabitants of the Chernobyl regions and their internal exposure in small doses - still
remains to this day: 17 years after the accident at the Chernobyl NPP.
The Byelorussian writer Ales Adamovich, A.D. Sakharov, the chairman of the
Peace Foundation and chess player Anatoly Karpov all suggested that I should organise an
Institute for radiation protection for the population of Belarus. First of all, the population
should have been informed about the actual radiation situation after the Chernobyl accident,
they should have been informed about the radionuclide contamination of foodstuffs and
nature gifts {sic}, and they should have been trained in simple radiation protection measures
for the inhabitants of the Chernobyl regions.
The Institute of Radiation Safety Belrad (Institute Belrad) was established in 1990.
The Institute Belrad suggested to the Supreme Soviet, the Byelorussian Government, and
the chairman of the Regional Executive Committees the creation of a network of local
centres for the radiation control of foodstuffs for the population (LCRC). Those suggestions
were included into the Law of the Republic of Belarus “About the Legal Regime of
Territories Contaminated by Radiation as a Result of the Catastrophe at the Chernobyl
NPP” with the following text in article 40 “In settlements located in zones of radioactive
contamination the State committee of the Republic of Belarus for overcoming the
consequences of the catastrophe at the Chernobyl NPP opens LCRC, when it is necessary,
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under the supervision of local authorities for the implementation of citizens’ requirements
connected with the testing of foodstuffs and things of general use”.
The Institute Belrad developed a β- and γ-dosimeter “Sosna”. Its production was
organised at the Institute and at the industrial works of Gomel, Borisov and Rechitsa (over
300 thousand devices were produced). At the same time the production of dosimeters
RKSB-104 was organised at Minsk industrial works.
Having developed and produced over 1,000 gamma-radiometers RUG-92 the
Institute Belrad promoted the equipping of radiological services of MAP, the Ministry of
Forestry, the Belarusian Cooperation Union and LCRC with reliable devices with a high
sensitivity range for the monitoring of Caesium-137 concentrations in foodstuffs, water and
the environment.
In the southern part of Belarus a network of 370 LCRC was organised. The first 30
LCRC were opened due to the financial support of the Peace Foundation of the USSR (A.
Karpov) and the Byelorussian Peace Foundation (M. Yegorov). The Chernobyl Committee
appointed the Institute Belrad the head organisation for creating and maintaining the LCRC
and consulting the population. In such centres, located at schools and at local administration
buildings, the population had the opportunity to measure the radionuclide concentration in
their foodstuffs and to get objective information about the safety of their use, as well as
advice on culinary processing techniques for radionuclide decontamination. The staff of the
Institute Belrad, in association with the local authorities, selected candidates from local
teachers, doctors, nurses and agronomists. They were educated at our Institute and received
certificates. Every month the radiometrists sent reports containing the results of the
radiation control of foodstuffs, nature gifts and fodder for the population. The Chernobyl
Committee played its part by paying for the production of devices for the LCRC and the
radiometrists’ wages.
Today, the radiation monitoring data (labelled with the surnames of the owners of
the foodstuffs) consists of over 350,000 samples and these data have informed the
construction of maps displaying the radiation contamination of milk, berries, mushrooms
etc.
Today, the number of LCRC supported by the Chernobyl Committee has been
reduced to 40 due to a reduction in financing, another 20 LCRC in Belarus continue to
operate due to the financial support of the German Chernobyl initiatives. Contamination
density of milk is a paramount risk factor for the health of the people, especially children.
According to the data of LCRC in the Gomel region and three districts in the Brest region,
about 15% of milk controlled by LCRC had Caesium-137 contamination above the
permissible level of 100 Bq/l.
As over 60% of the annual internal dose is received by children due to the use for
food of local milk contaminated by Caesium-137, it is considered to be the best indicator
for determining the safety of living within contaminated territories. In 2001 the number of
settlements producing milk with a Caesium-137 concentration exceeding permissible levels
was 326. According to the data of MPHS, milk was contaminated by Caesium-137 over 50
Bq/l (the permissible Caesium-137 concentration level for children’s food must not exceed
37 Bq/kg, l) in more than 1,100 villages in Belarus.
3. Permissible levels of radionuclide contamination of foodstuffs and the environment
under long-term radioactive contamination of the territory
Based on emergency dose limits of 10 rem during the first year, 5 rem in 1987, 3 rem in
1988, 3 rem in 1989, 0.5 in 1990 (50% of external dose, 50% of internal dose), in 1986,
1988 and 1991, MPHS of the USSR approved temporary permissible levels for Caesium-
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137 radionuclide concentration in foodstuffs and drinking water. Table 1 shows temporary
permissible levels (VDU-86, VDU-88, VDU-91), republican control levels (RKU-90) and
RDU-99) for Caesium-137 concentration in foodstuffs and drinking water.
Table 1. Temporary permissible levels (VDU-86, VDU-88, VDU-91),
Republican control levels (RKU-90) and republican permissible levels (RDU-92, RDU-96,
RDU-99) for Caesium-137 concentration in foodstuffs and drinking water
Foodstuff
Drinking water
VDU86
VDU88
VDU-91
RKU-90
RDU92
RDU-96
RDU-99
370
18.5
18.5
18.5
18.5
18.5
10
370
370
370
185
111
111
100
Concentrated milk
7400
1100
1100
370
Butter
7400
1100
370
370
3700
370
370
185
3700
2960
740
592
600
600
500
3700
1850
740
592
600
600
500
3700
1850
740
592
600
370
180
Vegetable fat
7400
370
185
185
185
185
40
Adipose,
margarine
7400
370
185
185
185
185
100
Potatoes, table
greens
3700
740
600
592
370
100
80
bakery
-
370
370
370
185
74
40
Flour, cereals,
sugar
-
370
370
370
370
100
60
3700
740
600
185
185
100
100
Fruits
3700
740
600
185
185
100
40
Garden berries
3700
740
600
185
185
100
70
-
-
1480
185
185
185
185
-
740
600
185
185
185
185
Milk and whole
milk products
Cottage cheese and
curd products
Meat and meat
products
beef
200
185
185
100
50
mutton
pork, poultry and
their products
Bread and
Vegetables and
edible roots
Wild berries and
preserved food
made from them
Tinned vegetables
and fruits, juice,
honey
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Fresh mushrooms
-
-
1480
-
370
370
370
-
11100
7400
3700
3700
3700
2500
-
-
-
592
370
370
370
Herbs, tea
-
-
7400
1850
Special products
for children of all
kinds, ready for
use
-
1850
185
37
Dried mushrooms,
dried fruits
Other foodstuffs
and food additives
37
The annual food allowance based on VDU-88 permitted internal dose (accepted by MPHS
in August 1990) was 0.7 to 0.8 rem/a. RKU-90. This was calculated in such a way that
internal dose would be 0.17 rem/a at the possible intake of radionuclides with foodstuffs. In
Belarus, current RKU-90 happened to be stricter than those accepted at the beginning of
1991 by MPHS of the USSR’s new temporary permissible levels VDU-91.
The principles of local radiation control consist of the obligatory thrice-repeated
control: at place of its production, when processing it and, at last, when purchasing
integrated products. During the first three-four years, radiation control centres were
introduced to all collective farms and state farms and also to all works for keeping,
processing and purchasing foodstuffs.
Today, according to the MPHS data, the intake of contaminated foodstuffs has not
been reduced, but the statutory permissible exposure levels have been diminished ten times.
During recent years dangerous levels of Strontium-90 contamination in grain, milk
and vegetables have been discovered at 28 Belarusian farms.
The Institute for Economics of the Academy of Sciences of Belarus has estimated
that, for a 30 year period, the economic damage for Belarus resulting from the Chernobyl
catastrophe will be 235 million USA dollars - that is 32 times the annual national budget for
the entire republic. Although the state spent from 20% to 6% of the annual budget for
Chernobyl programs over the years, this aid to the population of the affected regions was
insufficient and did not guarantee the safety of living within the contaminated territories.
The level of income of the inhabitants of these regions is too low for them to buy
clean, uncontaminated foodstuffs, thus they are forced to consume food contaminated with
Caesium-137. More than 80% to 90% of the annual dose (Caesium-137) is received by the
inhabitants because of their dependence on locally produced food.
The effects of long-term small doses of radiation influence negatively on the
health of the inhabitants of Belarus, especially children, who live in the Chernobyl regions
of the republic.
4. State of health of the population [5]
As a result of the Chernobyl catastrophe the population of Belarus was exposed and is
being exposed to the influence of negative factors, primarily radiation. All people within
the republic were irradiated by iodine radionuclides during the early period of the accident.
About 10,000 people had operations on thyroid cancer, including 1,800 children.
Among the population living or who lived on territories with a Caesium-137
contamination density over 37 kBq/m2 , the scientifically significant increase of the
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sickness rate by malignant diseases of the respiratory organs, digestive organs and by breast
cancer has been confirmed, as well as genetic dysfunctions and congenital malformations.
Other confirmed bodily diseases of the affected population include the
scientifically significant increase of the sickness rate by cataract and ischemia, of diseases
of the respiratory system, urogenital system, endocrine system, immune system, stomach
ulcers, duodenal ulcers and dysfunctions of metabolism.
Tremendous anxiety in this society is caused by the state of its children’s health
and characterised by the increase of the sickness rate and the decrease in numbers of
children classified as healthy (from 85% to 20% in the republic and to 6% in the Gomel
region).
5. Principles of radiation protection for the population of Belarus
In Belarus the following laws were accepted;
♦
Law of the Republic of Belarus “About the Social Defence of Citizens Affected by the
Accident at the Chernobyl NPP”, 1991;
♦
Law of the Republic of Belarus “About the Legal Regime of Territories Contaminated
by Radiation as a Result of the Catastrophe at the Chernobyl NPP”, 1991;
♦
Law “About Radiation Safety of the Population of Belarus”, 1998.
These Laws defined the average annual effective radiation exposure of the population to be
of 1 mSv/a. It is written in the addition and the modification of the Law of the Republic of
Belarus “About the Social Defence of Citizens Affected by the Accident at the Chernobyl
NPP” No 31-1 dated May 17, 2001:
“As an index of the assessment of the territory where the living and working conditions of
the population do not require any restrictions, the average annual effective radiation
exposure is set that must not exceed 1 mSv above the natural and man-made radiation
background.
If the average effective radiation exposure of the population exceeds 1 mSv/a radiation
protection activities must take place.
When the average effective radiation exposure of the population is reduced from 1 to 0.1
mSv/a the protective activities must not be cancelled, but their scope and character will be
regulated by the Council of Ministers of the Republic of Belarus.
When the average effective radiation exposure of the population is under 0.1 mSv/a above
the natural and man-made radiation background the protective activities do not take place
and the territory and the population living there is no longer considered under restrictions
concerning emergency radiation effects.”
It is known that for the dose limit of 1 mSv/a, the Chief Sanitary Inspector of
MPHS of the Republic of Belarus approved the dose limits of Caesium-137 and Strontium90.
Radionuclide concentrations in foodstuffs and drinking water (RDU-99) are based
on the annual actual food intake of the inhabitants of the Chernobyl regions. Unfortunately,
MPHS did not include the permissible Caesium-137 concentration levels in the basic dose
forming foodstuffs corresponding to the dose limit of 0.1 mSv/a. The dose limits are
calculated values and can not be measured and are unknown for the population. The set
permissible levels of radionuclide concentrations in foodstuffs, equivalent to 0.1 mSv/a,
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would be a definite guideline for the population for the lower safety limit of contamination
of foodstuffs.
In Russia (in 1999) and then in Belarus (in 2000) the following basic National
documents in the field of radiation safety and protection of the population were accepted:
♦
Norms of radiation safety and protection of the population.
♦ Basic sanitary rules for radiation prevention.
In Belarus the activities on overcoming the consequences of the accident at the Chernobyl
NPP are implemented within the framework of the special state programs financed from the
budget. The first program (1990 to 1992) was financed under conditions of the USSR.
From 1993 to 1995 and from 1996 to 2000 the republican state programs were
implemented. Today the State programs for overcoming of the catastrophe at the Chernobyl
NPP for the period 2001-2001 and up to 2010 are in use.
Apart from medical assistance for the population, the most important aspects of
the program are the implementation of protective activities on the most contaminated
territories, the receipt of exhaustive objective information about the radioactive
contamination of the environment, the radiation effects limits for the population, the
guaranteeing of agricultural production with radionuclide concentrations which do not
exceed the permissible levels, the reduction of radiation effects for the health of people and
the substantiation and adjustment of decisions
At one time spectrometers of human radiation (WBC = Whole Body Dosimeters) were
placed in all municipal, regional and republican hospitals. The Belarusian government
accepted the resolution obliging all heads of enterprises, ministers and departments to make
WBC-measurements of all inhabitants of the Chernobyl regions of Belarus. Unfortunately,
the low quality of existing WBC services resulted in the annual certification of less than
one third of the WBC by the State Committee on Standards. In the Slavgorod district WBC
have not been operating for 3 years, in the Bragin district for 2 years.
The WBC-measurements of Caesium-137 accumulation in the inhabitants of these
regions characterise the efficiency of the radiation protection activities for the population.
The absence of a system for practical WBC-monitoring of Caesium-137 accumulation
levels in the children of the Chernobyl regions and for testing their efficiency in the
implementation of radiation protection activities is especially pernicious.
Since 1995, the Institute Belrad has begun to create a network of mobile WBClaboratories for the monitoring of Caesium-137 accumulation levels in 500,000 children in
the Chernobyl regions of Belarus. There are now 8 mobile radiological WBC-laboratories,
but 15 are necessary.
Since 1996, the Institute Belrad has measured children on WBC to determine their
Caesium-137 accumulation. From 1996 to 2003, 190,000 children were measured on WBC.
Those measurements demonstrated that only 10 to 15% of children had an internal
Caesium-137 accumulation under 10 to 15 Bq/kg. The maximal Caesium-137 concentration
levels in children reach 4,000 to 7,200 Bq/kg. The medical investigations made by Doctor
of Medicine, Professor Y.B. Burlakova, an academic from the Russian Academy of
Sciences A.V. Yablokov (Russia), Professor Yu.I. Bandazhevsky and Professor T.A. Birich
(Belarus) demonstrated that pathological dysfunctions of important organs and systems of
children can appear at a Caesium-137 accumulation level in the organism of 30 to 50
Bq/kg. Heart muscle is especially sensitive to radiation contamination of the organism.
When having common meals (with radio-contaminated foodstuffs, as a rule) with
the family, children receive larger doses because their dose factors are 3 to 5 times higher
than those of adults, for this reason the Institute Belrad primarily selects children when
performing WBC investigations.
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In accordance with the Norms of Radiation Safety (NRS-2000) GN. 2.6.1.8-1272000, approved by the Ministry for Public Health Services of the Republic of Belarus in
2000 (Article 35) the annual population dose must not exceed basic dose limits (1 mSv/a).
These limits are related to the average dose in the critical group of population. In the NRS2000, in chapter 1, there is the following definition of the critical group within a population;
“this is a group of (not less than 10) persons from a population homogeneous in one or
several characteristics (sex, age, social and professional conditions, place of residence, food
intake) that is exposed by radiation, largely, in the present way of irradiation from the
present radiation source”.
To provide the statistical significance of the sample (σ = 0.95), in each settlement
the representative group of the population should be measured on WBC. Its number is
defined depending on the number of inhabitants, taking into account its social composition
and age (not less than 10% of all inhabitants of the present settlement). The critical group is
selected according to the results of these WBC measurements. The average value of
internal doses of the critical group (but not the average value in the whole settlement) is
considered as the annual internal dose for the present settlement and depending on this
value a decision on the necessity of radiation protection for the population is taken.
From 1999 to 2004 the Institute Belrad and the Nuclear Research Centre (NRC)
“Juelich” (Germany) implemented an international German-Belarusian project “Highly
Exposed Children” (over 20 thousand WBC measurements) approved by the
Komchernobyl, Gomel Regional Executive Committee, the Ministry for Emergency
Situations and The Commission for Problems of the Chernobyl Accident and the House of
Representatives of the National Assembly of the Republic of Belarus. In 1996 to 2003,
within the framework of the project, the results of WBC measurements of 137Cs in over
145,000 children from 250 villages of Belarus were systematized. Following the results of
analysis, in association with the Sakharov Radio-ecological University, maps were
constructed of radiation contamination of children from 13 (of 23) districts contaminated as
a result of the accident at the Chernobyl NPP. Similar maps were made for the Narovlya,
Yelsk, Bragin, Lelchitsy and Chechersk districts. (These maps are reproduced in the annexe
to this chapter).
Within the framework of the project with the NRC “Juelich”, 20,187 children
having the largest 137Cs in their organism were selected for further implementation of
WBC-monitoring and implementation of their radiation protection. In each village the
critical group (10 persons) having maximum levels of 137Cs s was selected. This analysis
permitted the identification of villages with the most exposed critical groups of children:
Svetilovichi of Vetka district (up to 1,536 Bq/kg); Valavsk (up to 744 Bq/kg), RozaLyuksemburg (up to 735 Bq/kg), Skorodnoye (up to 682 Bq/kg) of Yelsk district; Lenin (up
to 557 Bq/kg) of Zhitkovichi district; Beryosovka (up to 313 Bq/kg), Slobodka (up to 400
Bq/kg)
of
Kalinkovichi
district;
Klyapin
(up
to
667 Bq/kg), Litvinovichi (up to 544 Bq/kg) of Korma district; Dzerzhinsk (up to 254
Bq/kg), Glushkovichi (up to 753 Bq/kg), Grebeni (up to 898 Bq/kg) of Lelchitsy district;
Antonov (up to 830 Bq/kg), Verbovichi (up to 1708 Bq/kg), Golovchitsy (up to 743 Bq/kg),
Golovchitskya Buda (up to 358 Bq/kg), Grushevka (up to 760 Bq/kg), Demidov (up to
1,090 Bq/kg), Dzerzhinsk (up to 286 Bq/kg), Kirov (up to 1,993 Bq/kg) of Narovlya
district; Belyayevka (up to 561 Bq/kg), Polesye (up to 4,240 Bq/kg) of Chechersk district.
(See plates r – y)
As a rule, the critical, more vulnerable groups include children from families
consisting of many children, troubled families and families with a low income whose food
intake contains a great number of radio-contaminated local foodstuffs (milk, forest
products, game etc.).
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For joint measurements on the assessment of internal dose, age dependant factors,
published by the Nuclear Research Centre “Juelich” 05.11.2001 (Germany),were used,
although the ICRP constant values, (independent from age Кf) according to the results of
the summarizing of the data of the nuclear catastrophe in Japan, 1945, were used in
Belarus. It is obvious that the sensitivity of the growing child’s organism is, at least, ten
times higher than that of adults. Therefore, in the report, experimental WBC value for the
level of 137Cs s, but not calculated values of annual dose exposures of children are used. In
figure 2 the dependence of dose factor on age (data of the Nuclear Research Centre
“Juelich”, Germany) is given and was used for the calculation of internal dose.
The whole scope of WBC measurements of 137Cs s has been performed at the
Institute of Radiation Safety Belrad by the staff of the WBC laboratory with 8 mobile
gamma-spectrometers (“Skrinner-3M”) produced by the Institute for Medical and
Ecological Systems (Kiev, Ukraine) in association with the Institute Belrad.
Fig 2; Dependence of dose factor on age based on data from NRC “Juelich” (See text).
Dose factor, mSv/kBq*a
Fig. 2.23. Dependence of dose factor on human age for the
calculation of internal dose according to the data of the Nuclear
Research Centre “Juelich”, Germany
(received on 05.11.2001)
0.5
0.45
0.4
0.3
0.2
0.19
0.071
0.1
0.11
0.045
0.038
0
0
1
5
10
15
20
Age, years
The WBC laboratory was certified for independence and technical competence by the
National Body for Certification of the Republic of Belarus (Gosstandart) from 2001 to 2004
and from 2004 to 2007. The laboratory is certified annually by the National Body for
Certification of the Republic of Belarus. The automated complex “Skrinner-3M” was
included in the State Register of Measuring Instruments and was allowed to be used in the
Republic of Belarus (All measuring instruments must be verified by the Gosstandard every
year and the appropriate certificate is given). All assistants of the laboratory have a higher
education, were trained at the firm-manufacturer, received the corresponding certificates
and are fully trained in the operation of the complex “Skrinner-3M”.
In Table 3 there is minimal detecting activity (MDA) of eight complexes “Skrinner-3M”.
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Table 3 Minimal detecting activity (MDA) of WBC “SKRINNER-3M” of the Institute
Belrad with 30% error and confidence probability for t = 300 seconds and P=0.95 for a
‘phantom’ man (January 01, 2005)
No.
No. of WBC
MDA, Bq/kg
Child
Teenager
Adult
(11 kg)
(24 kg)
(64 kg)
1
232
13
9
7
2
234
14
9
7
3
240
13
9
6
4
243
13
9
7
5
245
14
8
6
6
246
12
8
6
7
251
12
8
6
8
255
19
12
8
From 2002 to 2004 the WBC laboratory performed triple intercalibrations in association
with the laboratory of the Nuclear Research Centre Juelich (Germany) with highly sensitive
spectrometers “Canberra” (MDA < 2 Bq/kg). The results of inter-calibrations did not show
any deviations from the international standards requirements. The high standards of
maintenance on all 8 WBC ensure the scientific accuracy of the results of the measurements
made with them.
It is known that, by 1990, at district territorial medical unions within the system of
the Ministry for Public Health Services of Belarus and at other Institutes there were 102
WBC. Some of these were designed on the basis of the spectrometer RUP-5 without the
necessary biological protections and with poor accuracy MDA, which are of little use for
measurements of 137Cs s in children. Over the last 18 years most WBC owned by the
Ministry for Public Health Services have become obsolete and this led to the fact that in
2003, when performing the certification by Gosstandart, 14 out of 29 WBC in the district
medical unions did not stand the test and were not certified.
When examining the Chechersk, Stolin, Slavgorod and Bragin districts within the
framework of UNDP in 2003, it was ascertained by the CORE group that the WBC in the
Bragin district hospital was out of order and had not worked for 2 years. The same situation
took place in the Slavgorod district and WBC in Stolin and Chechersk districts should have
been substituted urgently.
We can only welcome the decision made by the Swiss Cooperation Office, who
placed an order for a new WBC “Skrinner-3M” for the Bragin district, at its own expense,
within the framework of the CORE project.
It would be correct to do a full analysis of the technical state of WBC in all
districts of Belarus and to plan for their renewal within the next 2 or 3 years.
All measures for radiation and social protection of the population of the Chernobyl
regions (re-settlement of inhabitants, implementation of agrochemical measures in
agriculture, supplying children at schools and kindergartens with non-contaminated
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foodstuffs) were insufficient and did not ensure the decrease of 137Cs s in children under 15
to 20 Bq/kg. Therefore, natural biological sorbents for the decontamination of children
from radionuclides and heavy metals must be applied.
It must be admitted that information and educational programs for up-grading the
radiation knowledge of the population turned out to be insufficient. There is a need within
the system for radio-ecological education of the population (especially among children,
young people and young parents) at schools, kindergartens, educational establishments and
for training in simple methods of radiation protection and means of preventing radionuclide
entry into the children’s bodies with local foodstuffs. In each district and settlement
programs on the introduction of chemical fertilizers to agricultural holdings (including
private households), pastures, hayfields and in forests (in places where berries and
mushrooms are gathered within a radius of 5 to 10 km from villages) should be performed
once every 3 or 4 years for the significant reduction of radionuclide transfer from soil to
plants.
In 1992 the Ministry for Public Health Services of the Republic of Belarus
published a Catalogue of Dose Burdens of the population for 3,668 settlements within the
republic. Unfortunately, when making the catalogue of dose burdens, MPHS made the
principle mistake of determining the annual dose burdens in each settlement based on the
radioactivity of 10 milk samples and 10 potato samples, this resulted in the inauthenticity of
the data and to the depreciation of annual dose burdens in the whole.
It was wrong to use data drawn from legislation aimed at minimising the
magnitude of exposure of the population for epidemiological purposes. In determining the
average annual dose burden value (collective dose) in order to determine the expected
number of patients for purposes of radiation protection, it is important to single out the
critical group (10 of the most irradiated persons) and to guarantee such protective measures
that the annual dose burdens in the critical group will not exceed 0.3 mSv/a (according to
Radiation Safety Norms). In the field of radiation protection there is the principle of the
‘critical group’ when taking into account protection aimed at the most vulnerable groups
and the weakest members of the population (children, pregnant, old people).
In 1998, 2000, 2002, MPHS made attempts to accept the new Catalogue of Dose
Burdens of the population of Belarus. The Chernobyl Committee and the House of
Representatives of the National Assembly of Belarus organised a commission of experts
that carried out direct WBC-measurements of 5,000 inhabitants (mainly children) in 45
villages. Those measurements showed that the calculated dose values (for 10 milk and 10
potatoes samples) of the new Catalogue were underestimated by 6 to 8 times in comparison
with the true dose burdens. These results were first reported at the inter-departmental
commission and then at the Parliamentary Assembly, the claims were considered as
ungrounded and MPHS was forced to remove the new Catalogue of Dose Burdens as
inauthentic.
Unfortunately, in summer 2002 MPHS and the National Commission for
Radiation Protection (NCRP) introduced new motions to the government of the republic
and on August 8, 2002 the Council of Ministers of Belarus approved a new zoning strategy
for the territories according to levels of radiation contamination: 146 villages were
excluded from the list of objects which are situated within the contaminated territories.
These villages were considered to be clean. As a result, the children from these villages
were deprived of uncontaminated meals at school canteens and of the annual rehabilitation
programs offered at sanatoria in clean regions within the republic, financed by The State
Chernobyl Program.
It is very important to develop a system of information and education for the
population in order to promote the implementation of scientific and medical
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
recommendations in the field of living safely within the contaminated territories. It is
necessary to study not only the sickness rate of the population in the Chernobyl regions, but
to implement the necessary radiation protection activities and the treatment of the suffering
population.
Listed below are some of the activities that were implemented for minimising internal
exposure of the population:
♦
Re-settlement (135 thousand persons were re-settled);
♦
Cultivation of pastures and hayfields, agrochemical protective activities in agriculture
(about 0.5 hectares of pastures and hayfields per cow were cultivated only once during
a span of 17 years and it is necessary to do this every 3or 4 years);
♦
Mixed fodder with sorbents and boles in cattle-breeding (the production of mixed
fodder with sorbents (Prussian blue), calculating 50 kg per cow, was organised at 5
works (200 to 250 kg per cow are needed);
♦
Meals for children at schools and kindergartens due to the Chernobyl Programme,
annual rehabilitation in clean districts and abroad;
♦
Organisation of the production of food supplements and their inclusion in the food
allowance for decontamination of the organism from radionuclides and heavy metals.
There are some medical works written by scientists from Russia, the Ukraine and Belarus
that show that when radiocaesium is 50 to 70 Bq/kg, pathologies of vital systems in
children’s bodies can appear. The National Report of Belarus 2003 mentions that the main
concern “within this society is that of the state of health of the children living within
territories with a radiocaesium contamination density of 37 to 555 kBq/m2 which is
characterized by an increase in the sickness rate, a decrease in the number of fully health
children and an increase in immune system disorders”
Catastrophic deterioration of the heath of the population has occurred (especially
children: In 1985, 85% of children were regarded as fully healthy - in 2001 that figure was
reduced to 20%) 20 years after the Chernobyl accident we must conclude that people have
not become ill because of stress, radiophobia and over-population, but because of the
effects of long-term small radiation doses, because of the continual consumption of radiocontaminated foodstuffs and because of the inability to provide the population of the
Chernobyl regions and the whole of Belarus with non-contaminated foodstuffs and other
protective measures with the financial resources of one country.
In state structures of the Ukraine, Belarus and Russia the effectiveness of using
enterosorbents, for the removal of radionuclides from the bodies of animals in order to treat
meat and milk, has already been recognized. In Belarus the production of mixed fodder for
cows, containing Prussian Blue, has already been implemented.
It would be beneficial for the population of Belarus to organise the production of
pectin food additives for the quick removal of radionuclides from the inhabitants
consuming 137Cs contaminated local foodstuffs.
In the Ukraine, food supplements made from apple, beet and citrus
polysaccharides, used for the quick removal of radionuclides, are produced at 7 enterprises.
The senior staff at the Centre for Radiation Medicine of the Ministry for Public
Health Services of the Ukraine, the Institute for Radiology of the Academy of Sciences of
the Ukraine and the staff of the former Institute for Radiation Medicine of the Ministry for
Public Health Services of Belarus performed clinical tests on pectin food additives [4, 5],
testing their efficiency with the use of WBC, and advised the intake of pectin food
additives, for practical radiation protection, not less than 4 times a year (each quarter).
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In 1998 the Ministry for Public Health Services of the Ukraine published an
information list for the leaders of regional departments for public health services
concerning the effectiveness of pectin food supplements “Yablopect” (Dnepropetrovsk,
Ukraine) on the inhabitants of radio-contaminated territories and for the recovery of those
affected by the Chernobyl accident. We think that this is an important radiation protection
measure for children that accelerates the removal and decreases level of radionuclides and
heavy metals in children.
The Institute Belrad used the French pectin additive “Medetopect” until 1996 and
the Ukrainian pectin preparation “Yablopect” was then used until 2000, in order to
decontaminate the bodies of children from radionuclides. From 1998, this work was carried
out by the Institute Belrad in association with the international Chernobyl initiatives.
In 1999, within the framework of the joint project with the Austrian Chernobyl
initiative, an annual cycle of radiation protection of 1,000 children was implemented in 8
villages. Using WBC controls, these tests revealed a two to four-fold reduction in
radiocaesium in children within one year after the use of pectin preparations,
Shown in the annexe is a graph of variations in the average specific activity of
137Cs radionuclides in children from the Sivitsa basic school of Volozhin district of Minsk
region.
In Belarus there are sufficient resources of raw materials (apple extraction at 20
canning factories) for the production of pectin food supplements. In April 2000, the
Institute Belrad received permission from the Ministry for Public health Services to
produce and provide the dried apple vitamin drink “Vitapect” made from apple pectin with
additional vitamins В1, В2, В6, В12, С, Е, β-carotene, folic acid and microelements K, Zn,
Se, Ca. The production of the preparation “Vitapect” was organized at the laboratory of the
Institute Belrad at The Charity House.
Following the work of The Chernobyl Committee of Belarus, comparative tests on
the efficiency of pectin and vitamin preparations “Medetopect” (France), “Vitapect”
(Institute Belrad), Spirulina (Russia) and the vitamin preparation “Vitus-Iod” were carried
out at the sanatorium “Belarus”. Groups of children (up to 30 persons in each group) took
these preparations twice a day over 21 days. WBC-measurements made before and after the
intake of these preparations demonstrated a decrease in the Caesium-137 concentration in
these children:
•
•
•
•
46 to 49% decrease when taking pectin;
31 to 35% decrease when taking Spirulina;
23% decrease when taking “Vitus-Iod”;
18% decrease in the control group (without taking these preparations).
When the effectiveness of the pectin preparation in removing 137Cs from the human
organism was called into question, we performed a double blind trial in accordance with
international standards. 64 children took part during their recovery at the sanatorium while
eating clean foodstuffs.
The association “Children of Chernobyl Belarus” (France) suggested testing the
efficacy of the pectin preparation “Vitapect” in comparison with a “Placebo” (based on fruit
‘kissel’). The trial took place in June and July, 2001 at the sanatorium “Serebryanye
Klyuchi” while consuming uncontaminated food and in accordance with the double blind
method. With the cooperation of children and parents, two groups of children were
selected. Each group consisted of 32 persons, with one group taking 10 grams of the pectin
food additive “Vitapect” daily over 21 days and the second group taking the “Placebo” over
the same period. The decrease of 137Cs in children taking the “Vitapect” was 65.6%, those
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taking the “Placebo” – 13.9%. This statistical difference is scientifically significant (р <
0.01).
From 2000 to 2002 the Institute Belrad, in association with the Chernobyl
initiatives from Italy (650 children), Ireland (1,100 children) and England (1,215 children),
performed the following projects: children traveling for recuperation were measured on
WBC for identification of 137Cs in their bodies; within the recuperation period they took
pectin preparations and after their recuperation they were measured on WBC for the second
time. A control group was selected that had not received the pectin preparation within the
recuperation period abroad. The second WBC measurement (between 26 to 28 days)
demonstrated a reduction of the 137Caesium from 60% to 85% in children having taken
pectin within the rehabilitation period and 15% to 20% in the control group (those who had
not taken the pectin preparation).
In association with the Chernobyl initiatives from Austria, Germany and France, a
project was realized that included giving 3 to 4 cycles of “Vitapect”, over the course of a
year, to children returning from their recuperation. In this study 137Cs in the children were
reduced by 2 to 3 times.
A course of radiation protection for 1,400 children in 10 villages of the Narovlya
district including the use of “Vitapect” (5 cycles of the “Vitapect” intake and tenfold WBC
monitoring of 137Cs in children before and after taking the preparation) was implemented by
the Institute Belrad (from 2000 to 2002) together with the association “Children of
Chernobyl Belarus” (France), The Mitterrand Foundation and the fund “Children of
Chernobyl”. This study demonstrated the possibility of reducing annual radiation exposure
by 3 to 5 times. The performance of this international project, in coordination with local
authorities, incurred little financial costs and is considered to be a good example of the
efficiency of such international aid. In the annexe to this chapter are graphs showing
variations in the average specific activity of 137Cs radionuclides in children in the villages
of Verbovichi and Kirov. These graphs clearly show an increase of 137Cs in children after
stopping the “Vitapect” intake.
Among recuperating children in Normandy (France), the French laboratory ACRO
tested 137Cs in children’s urine before and after taking “Vitapect”, and the Institute Belrad
performed WBC measurements of 137Cs in children before and after taking “Vitapect”. In
figure 2.28 in the annexe there is a graph showing the variation of 137Cs in the whole
organism before and after taking “Vitapect” over 21 days. The reduction of 137Cs in the
organism was 61%.
Over recent years the carers and parents of many hundreds of Belarussian children
appeared in Germany (Bremen, Hannover, Bonn, Lüneburg, and Göttingen), Austria (Tirol)
and France (Normandy) to obtain pectin preparations. An information certificate is kept for
each child that contains the changes of 137Cs in the body (there are three copies– one with
the host family, one for the child’s family and one kept at the Institute Belrad). Within the
last 4 years the Institute Belrad has given the pectin food supplement “Vitapect” to 75
thousand children from the Chernobyl regions of Belarus.
An important property of the pectin preparations should be mentioned: if heavy
metals and radionuclides are removed from the organism the positive balance of vitally
important microelements is restored. From 2003 to 2004, within the framework of the
international project “Highly Exposed Children of Belarus”, the efficiency of “Vitapect” vs.
the “Placebo” in children was studied over an 8 week period at the sanatoria “Lesnye Dali”,
“Serebryanye Klyuchi” and “Belorusochka” with the agreement of the children and their
parents. The influence of the pectin preparation on blood composition and general
recuperation were examined. As well as the three sanatoria, partners for the implementation
of the project were the Central Research Laboratory (TsNIL) of the Belarusian Medical
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Academy for Postgraduate Education (BELMAPO) of the Ministry for Public health
Services of Belarus. Within the radiological section of the project the WBC laboratory of
the Institute Belrad performed measurements of 137Cs in children, during their stay, before
and after the intake of “Vitapect” and “Placebo”. This project consisted of radiological and
medical investigations.
Within the radiological section of the project, measurements of 137Cs in children
were performed within each recuperation period before and after the intake of “Vitapect”
and “Placebo”. At the same time radiation control of foodstuffs contributing to the food
allowance for children was carried out. In figure 2.30 in the annexe there is an evaluation of
the efficiency of “Vitapect” and “Placebo” for the removal of radionuclides from children
in the group having taken “Vitapect” and in the control group having taken “Placebo”.
The medical part of the project, namely blood sampling, was performed by the
medical staff at the sanatorium and the samples were tested by the physicians of TsNIL
BELMAPO of the Ministry for Public Health Services of Belarus. A medical checkup of
the children was carried out, including functional exercise testing with measurements of
blood pressure before and after exercise testing. ECG recordings were made at the
beginning and at the end of the recuperation period. Tests for the essential microelements in
blood (Zn, Fe, Cu) and for potassium were made at the beginning and at the end of the
recuperation period in order to investigate the influence of “Vitapect” on microelementary
balance in children.
The application of the pectin preparation “Vitapect” over 12 to 14 days promotes
the removal of incorporated 137Cs radionuclides and helps maintain a positive balance of
potassium, copper, zinc and iron in children. The reduction of these elements in blood
serum has not been observed in tested groups (see annexe).
During their stay at the sanatorium one group of children took the preparation
“Vitapect”, 5 g two times a day, the second group took the preparation “Placebo” 5 g two
times a day. Medical checkups were made twice during the 12 to 14 day interval (at the
beginning and at the end of the recuperation period). Presented in the annexe is the
diagram showing the responses of the ECG to varying accumulations of Cs-137 in 543
children examined in villages in contaminated districts of Belarus since 2003 and a diagram
representing changes in vascular response, with average specific activity of Cs-137.
This work was carried out in accordance with the double blind method of research.
The lists of children were decoded after completing all measurements, all medical
examinations were conducted in the presence of representatives of the Nuclear Research
Centre “Juelich” (Germany).
Before starting the measurements connected with that stage of the project, from
October 30 to November 01, 2003, the intercalibration of WBC from the Institute Belrad
and the Nuclear Research Centre “Juelich” (Germany) was performed and the certificates
of the State Metrological Verification of Spectrometers of the Institute Belrad were
examined at the Komchernobyl Children Republican Recuperation Centre “Zhdanovichi”.
6. Participation of the non-governmental Institute of Radiation Safety Belrad in
overcoming the consequences of the Chernobyl accident in Belarus
During the first years of the Institute Belrad’s work, when the Supreme Soviet of the USSR
and BSSR made a decision to remove from the secrets list all the material on the Chernobyl
accident, the inhabitants of Belarus began to mistrust official government information
regarding the levels of contamination in the territory and foodstuffs.
In 1989 the government of Belarus began to acquire staff from the nongovernmental Institute of Radiation Safety Belrad (between 1989 to 1990 referred to as the
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Scientific and Technical Centre for Radiation Safety “Radiometer”) to take part in
commissions for the assessment of the radiation situation and the implementation of
radiation protection measures for the population. In 1989 and 1990 the Council of
Ministries of Belarus (chairman – Professor V.B. Nesterenko), consisting of specialists in
radiation protection, agricultural radiology, forestry, medicine and sociology, made
thorough investigations of the villages Chudyany (> 147 Ci/km2), Malinovka and Maysky
in the Cherikov district of the Mogilyov region. The proposals of the Commission were
accepted by the government and the inhabitants of these villages were re-settled. Six
months later the same commission made further investigations of the village of Veprin in
the Cherikov district. Following the results of the commission, all children were sent to
sanatoria in Russia for several months of rehabilitation, all inhabitants of these village were
re-settled, all activity was terminated and the village was land-buried (the streets were
contaminated with a Caesium-137 density over 55 Ci/km2).
In 1990 and 1991 the commission investigated living conditions and the possibility
of production of foodstuffs containing Caesium-137 within the limits of the RDU-90
(republican permissible levels).Following this, some villages within the Narovlya district
went on strike. According to the results of the work of the commission, 65 villages were
discovered to have dose burdens in excess of the 35 rem life-time dose. The government
made a decision to re-settle 8 villages from the Narovlya district and some of the
inhabitants, including their children, from the settlement Narovlya.
In the autumn of 1991 the commission, on behalf of the government of Belarus,
made thorough investigations of the villages Ol’myany, Gorodnaya and other villages
within the Stolin district. The commission worked closely with local authorities, schools
and the entire population. In all villages LCRC for informing the public were organized and
additional radiation protection measures for children (uncontaminated meals at schools,
year-long double rehabilitation in sanatoria within uncontaminated regions of Belarus etc.)
were accepted.
As a result of this work a network of 20 LCRC was organized in the Stolin district,
5 of which were used in implementing the ETOS project.
The next fundamental stage in informing the population, implemented by the
Institute Belrad, consisted of developing a program of WBC-radiation monitoring of
Caesium-137 accumulation levels in children and discovering ways of lowering these
levels.
In 1995 the Institute Belrad began to investigate the feasibility of mobile WBClaboratories for determining Caesium-137 accumulation levels in children. Due to the help
of the Chernobyl initiatives from Germany, Ireland, Norway, the USA and the World
Church Council, 8 mobile laboratories were developed using mini-buses, which had been
presented to the Institute Belrad by the Irish Chernobyl Children Project and the Vienna
City Council.
By the end of the year 2003, over 200,000 WBC-measurements of children were
performed at schools and kindergartens in the Chernobyl regions of Belarus. High
Caesium-137 accumulation levels in children were discovered; their maximum value
reached 4,000 to 7,000 Bq/kg of body weight (BW) per child.
This information was submitted to parents, schools and regional administrations.
The results of the WBC-measurements were integrated and published with the permission
of the parents and children on the information lists, which were submitted to the
Government, Presidents’ Administration, the Ministry for Public Health Services (MPHS),
all governors, executive committees and all LCRC, to inform them and to discuss protective
measures.
205
ECRR 2006: CHERNOBYL 20 YEARS AFTER
On behalf of The Ministry for Emergency Situations (MES) and The Commission
of the Chamber of Representatives for the Problems of the Chernobyl Accident, the
Institute Belrad was brought in as experts to investigate actual Caesium-137 accumulation
levels in the inhabitants of 45 villages, previously declared by the MPHS as ‘safe’. The
WBC-measurements demonstrated that the actual annual dose burden of the inhabitants of
these villages were 6 to 8 times higher than those in the Dose Catalogue submitted by
MPHS to the Government of Belarus. In April 2000 the results of the work of the
commission were reported at the special session of the Chamber of Representatives for the
Problems of the Consequences of the Chernobyl Accident. The proposals of the
commission (chairman V.B. Nesterenko) were accepted and MPHS was obliged to recall
the draft of the Catalogue of Annual doses for the population of Belarus (2000) from the
Government and to send it to the Institute for Radiation Medicine and Endocrinology for
revision.
The following day the medical commission came to the Institute Belrad with
instructions from the MPHS of Belarus (Minister I.B. Zelenkevich) concerning a
prohibition on the Institute Belrad on performing WBC-measurements on the inhabitants.
The reason given was that the procedure was, essentially, a medical one and the Institute
should have obtained a medical license from MPHS. In a special letter MPHS sent
directions to all public health structures ordering the withdrawal of their contracts with the
Institute Belrad as it did not possess the necessary medical license.
The Institute Belrad did, however, have a license from the MES of Belarus for the
performance of radiation control in the environment and foodstuffs. The decision of the
Minster for Public Health Services was appealed in a letter to the President of the Republic
of Belarus. On behalf of the Administration of the President, MES carried out an
international examination of Belrad’s project - “WBC Radiation Monitoring of
Radionuclide Accumulation in Children and Their Protection with Pectin Preparations”.
International experts from Russia, the Ukraine, Belarus and France confirmed that WBC
measurements were a physical procedure and the Ministry of Justice of Belarus confirmed
that the Institute Belrad, having a license for radiation measurements, did not need a
medical license.
MPHS and the Institute Belrad have a data base of WBC measurements of
Caesium-137 accumulation levels in children from the Chernobyl regions (maps of
radiation contamination of children from 12 districts have been constructed and are shown
in the annexe to this chapter). Protective measures should be ensured in such a way that the
annual dose burden in the critical group does not exceed 0.3 mSv/a and, in the whole
settlement, to remain under 0.1mSv/a, as is stated in the addendum and the modification of
the Law of the Republic of Belarus “Regarding the Social Protection of Citizens, affected
by the Accident at the Chernobyl NPP” #31-1 dated to May 17, 2001. Provided that
adequate financing of the Chernobyl program is in place, such an approach would help to
identify the most critical groups, including the most irradiated groups of children from
families with many children, and of extended families in each village. In addition, this
would help to ensure that the State Chernobyl program could provide the necessary food
allowances at schools and annual rehabilitation.
All the results of the WBC-measurements were sent to the local authorities for
consultation.
In the Decree of the Council of Ministers of the Republic of Belarus, MPHS was
ordered to prepare the Catalogue of Dose Burdens of the population of Belarus. The
Republican Scientific and Practical Centre for Radiation Medicine and Human Ecology
(RSPC RM&HE) in Gomel prepared the “New Methods of Calculation of the Annual
Doses of the Population” which are based on the hypothesis of proportionality between the
206
ECRR 2006: CHERNOBYL 20 YEARS AFTER
annual dose burden of the inhabitants of the Chernobyl regions and the contamination
density of the territory. The members of the Institute Belrad (Professor V.B. Nesterenko
and Professor A.N. Devon) were included in the commission of experts of the National
Commission for Radiation Protection for the assessment of the scientific significance of
the “Methods of Determining Annual Dose Burdens of the Population of Belarus” proposed
by RSPC RM&HE (Gomel). The Institute Belrad submitted to the committee of experts the
results of the processed WBC-measurements for 97 villages in the Gomel region, 9 villages
in the Mogilyov region and 18 villages in the Brest region. The coefficient K value (relation
of the average specific radionuclide accumulation in inhabitants to the contamination
density of the territory) varies from 0 to 354 in the Gomel region, from 7 to 95 in the
Mogilyov region and from 6 to 85 in the Brest region.
This showed that the main hypothesis of the authors of the “Methods of
Determining Annual Dose Burdens of the Population of Belarus” based on the radiation
contamination density of soil had no scientific grounding and it was therefore rejected by
the National Committee for Radiation Protection.
A new Catalogue of Dose Burdens of the population must be developed, based on
the Belgidromet direct measurements of dose rate in each settlement (external exposure
dose) and the internal exposure dose of the inhabitants of each settlement should be
determined according to the dose burden for the most critical and most irradiated groups of
inhabitants (10 to 15 persons). This is received through direct WBC-measurements of the
representative group of inhabitants.
At the Gomel RSPC RM&HE the lack of data from direct WBC-measurements of
radionuclide accumulation in the inhabitants of several villages of the Gomel region, and
especially in the Brest and Mogilyov regions, was conspicious. The Institute Belrad offered
the use of its mobile WBC units to the administration of RSPC RM&HE in order to gather
this missing information (not less than twice a year in each settlement). The proposal has
not yet been accepted.
The measuring abilities of the mobile WBC-laboratories of the Institute Belrad are
capable of performing measurements on 55,000 to 60,000 persons a year and ensuring
reliable data on the radionuclide accumulation level in the inhabitants of the villages most
contaminated by Caesium-137.
Direct WBC-measurements will help to identify the most irradiated groups of the
population in the Chernobyl regions of Belarus and to address the issues of radiation
protection for the population of the republic.
Since 2000, the Institute Belrad’s laboratory installation produces more than 1,500
packs of pectin food supplement "Vitapect" per month. Over the years, due to international
help from Chernobyl initiatives, the Institute Belrad has been able to supply "Vitapect" for
75,000 children in the Chernobyl regions of Belarus.
Because of the enlargement of its laboratory facilities in 2005, the Institutes’ new
“House of Belrad”, has been able to produce 5,000 -7,000 packs of “Vitapect" per month.
The Irish Chernobyl initiative (the Chernobyl Children’s Project) has delivered a press to
the Institute for the production of water-soluble tablets containing pectin. A series of
foreign Chernobyl initiatives are in place to seek financial help for the expansion of the
production of «Vitapect" for radiation treatment for the children of Belarus.
In October 2005, the Institute of Fruit Growing of the National Academy of
Sciences of Belarus has offered the Institute Belrad cooperation in the organization and
manufacture of pectin food supplements.
207
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Conclusion
1.
Implementation of regular WBC measurements on all children in the Chernobyl
regions of Belarus is instrumental in identifying nominal critical groups of
children with the greatest levels of radiocaesium accumulation in their bodies and
opens a pathway to selective priority for radiation protection.
2.
It is recommended that the Ministry of Agriculture and Food Production of
Belarus should organize, at available canneries within Belarus, the production of
pectin food additives from apple-seed meal, and for the Ministry of Public Health
and the Ministry of Health of Ukraine to call for the inclusion of pectin food
supplements (3-4 times in year) in a regular diet as a means of purification of the
bodies of children from radioactive nuclides and heavy metals.
3.
There is a need to initiate joint research in order to investigate frequency of
disease within the population (especially liquidators and children) relative to Cs137 content and the influence of radio caesium in their bodies on a host of diseases
(heart, kidneys, eyes, endocrine system, etc.).
4.
An increase in the number (up to 150-160) of Local Public Centres of Radiation
Control of foodstuffs (LCRC) in the contaminated regions is recommended. This
would supplement the existing state system of radiation control of food stuffs and
could also be an educational base for the population, becoming information
centres of radio-ecological education for schoolchildren, their parents and
teachers.
5.
It is extremely necessary to increase (up to 12-15) the number of mobile WBC
laboratories for taking regular measurements of the population and identifying
critical groups where dose burdens exceed 1 mSv/year.
6.
It is necessary to organize commercial production and regular application of pectin
food supplements (made from apples, algae) as an efficient radiation protection
treatment for the population of the Chernobyl regions of Belarus.
7.
It is necessary to initiate large scale international projects for radiation protection;
these include developing the use of pectin food additives and WBC measurement
strategies as an aid towards radiation protection for the public.
Experts:
Professor V.B. Nesterenko
Expert-Ecologist A.V. Nesterenko
References
Chernobyl Catastrophe: Causes and Effects. Expert’s conclusion of 4 parts (in Russian and
English), about 800 pages.
Part 1. Direct Causes of the Accident at the Chernobyl NPP. Dosimetric Monitoring.
Protective Activities and Their Efficiency. 1993.
Part 2. Biomedical and Genetic Effects of the Chernobyl Accident. 1993.
Part 3. Effects of the Catastrophe at the Chernobyl NPP for the Republic of the Belarus.
1992.
Part 4. Effects of the Catastrophe at the Chernobyl NPP for the Ukraine and Russia. 1993.
V.B. Nesterenko. Chernobyl Accident: Radiation Protection of Population, Minsk, 1998,
page 172.
208
ECRR 2006: CHERNOBYL 20 YEARS AFTER
I.N. Nikitchenko. Chernobyl. How Does It Happen. Minsk, Committee for Protection of
Rights of Industrial Classes, 1999, page 193.
V.F. Ageyets. System of Radioecological Counter-measures in Agrosphere of Belarus.
Minsk, 2001, page 249.
Consequences of Chernobyl in Belarus Since 17 Years, National report. Minsk, Committee
on Problems of the Consequences at the Chernobyl NPP of the Council of Minister
of Belarus, page 52.
Professor, Doctor of Medicine Yu.I. Bandazhevsky. Biomedical Effects of Radiocaesium
Incorporated into the Body. Minsk, 2000, page 70.
V.B. Nesterenko. Recommendations on Radiation Protection of Population and Their
Efficiency. Minsk, 2001, page 58.
Law of the Republic of Belarus “About the Social Defence of Citizens Affected by the
Accident at the Chernobyl NPP”, February 22, 1991;
Law of the Republic of Belarus dated 17.05.2001. Addenda and amendments to the Law of
the Republic of Belarus “About the Social Defence of Citizens Affected by the
Accident at the Chernobyl NPP”;
Law of the Republic of Belarus “About the Legal Regime of Territories Contaminated by
Radiation as a Result of the Catastrophe at the Chernobyl NPP”, November 12,
1991;
I.M. Bagdevich. Guide for Carrying on Agroindustrial Enterprise in Conditions of
radiocontaminated Soil of the Republic of Belarus for 1997 to 2000. Minsk, 1997,
page 76.
The report of World Bank No 23883-BY “Belarus. The review of consequences of accident
on Chernobyl NPP and programs on their overcoming”. Minsk, 2002, 64 pages.
The report of the United Nations 2002 “Humanitarian consequences of accident on the
Chernobyl NPP. Strategy of rehabilitation”. Minsk, Yunipаk, 2002, 73 pages.
Professor, Doctor of Medicine M.I. Rudnev. The Opinion About Protective Properties of
the Apple Powder Containing Pectins in the experiment of the influence of small
doses on the human body. Science centre for Radiation Medicine of Medical
Academy of Sciences of the Ukraine, Kiev, 1997.
L.V. Porokhnyak-Ganovskaya. The New Way for Prevention And Rehabilitation of the
Inhabitants of the Zone of Radiation Contamination: Pectin Apple Powder And
Vitaminized Water-soluble Pills “Yablopect”. Medical adviser, No 1, 1998.
N.A. Gres etc. Influence of Pectin Preparations on Dynamics of the Microelement
Composition of Blood of Children. Digest of Research Clinical Institute of
Radiation Medicine and Endocrinology, Minsk, 1997, pages 108-116.
N.A.Gres, A.N.Arinchik, etc. Peculiarities of the microelement composition of the
children’s bodies in Belarus. Digest Research Clinical Institute of Radiation
Medicine and Endocrinology, Minsk, 1997, pages 26-29.
Joint report IRS Belrad and Research centre in Juelich (Germany) under the international
project “Highly irradiated children in Belarus” (4th milestone) “Efficiency of
excretion of radioactive nuclides of cesium - 137 from an organism of children by
pectin preparation "Vitapect", conservation and stabilization of balance of the
vital microelements by it (K, Zn, Fe, Cu). Minsk, Juelich, 2004, 20 pages.
V.B.Nesterenko, A.V.Nesterenko, V.I.Babenko, T.V.Yerkovich, I.V.Babenko. “Reducing
the 137-Cs-load in the organism of Chernobyl children with apple-pectin”. Swiss
Med Wkly, 2004, 134, 24-27.
G.S.Bandazhevskaya, V.B.Nesterenko, V.I.Babenko, I.V.Babenko, T.V.Yerkovich,
Yu.I.Bandazhevsky. “Relationship between Cesium (137Cs) load, cardiovascular
209
ECRR 2006: CHERNOBYL 20 YEARS AFTER
symptoms, and source of food in “Chernobyl” children – preliminary observations
after intake of oral apple pectin.” Swiss Med Wkly, 2004, 134:725–729.
V.B.Nesterenko, P.Hill, M.Schläger, H.Dedviichs, R.Lennartz, R.Hille, A.V.Nesterenko,
V.I.Babenko. “Evaluation of the Current Radiation Burden of Children Living in
Regions Contaminated by the Chernobyl Accident”, IRPA-congress at Madrid in
Spain, 2004.
210
ECRR 2006: CHERNOBYL 20 YEARS AFTER
ANNEXE TO CHAPTER 12
Figures, maps and diagrams referred to in the text
Belrad contamination data maps
1. Vetka district, village Svetilovichi
The density of contamination of territory by Cs-137 – 22,01 Ci/km2, dose of external
irradiation – 1,0 mSv/a, population – 1042 people (181 schoolboy, in kindergarten – 52
children), quantity of measurements on February 28, 2002 – 152.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Svetilovichi of Vetka district of Gomel region (28.02.02)
11
12
under 20 Bq/kg
20-70 Bq/kg
32
70-200 Bq/kg
more than 200
Bq/kg
97
2. Elsk district, village Valavsk
The density of contamination of territory by Cs-137 – 9,44 Ci/km2, dose of external
irradiation – 0,4 mSv/a, population – 819 people (127 schoolboys, in kindergarten – 39
children), quantity of measurements on May 12, 1998 – 213.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Valavsk of Elsk district of Gomel region (12.05.98)
14
15
under 20 Bq/kg
20-70 Bq/kg
75
109
70-200 Bq/kg
more than 200
Bq/kg
211
ECRR 2006: CHERNOBYL 20 YEARS AFTER
3. Elsk district, village Roza-Luxemburg
The density of contamination of territory by Cs-137 – 10,54 Ci/km2, dose of external
irradiation – 0,5 mSv/a, population – 293 people (72 schoolboys, in kindergarten – 18
children), quantity of measurements on December 5, 2001 – 107.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Roza Luxemburg of Elsk district of Gomel region (05.12.01)
1
33
25
under 20 Bq/kg
20-70 Bq/kg
70-200 Bq/kg
more than 200
Bq/kg
48
4. Elsk district, village Skorodnoe
The density of contamination of territory by Cs-137 – 6,46 Ci/km2, dose of external
irradiation – 0,3 mSv/a, population – 747 people (200 schoolboys, in kindergarten – 52
children), quantity of measurements on January 11, 2000 – 242.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Skorodnoe of Elsk district of Gomel region (11.01.00)
30
7
under 20 Bq/kg
20-70 Bq/kg
101
70-200 Bq/kg
more than 200
Bq/kg
104
212
ECRR 2006: CHERNOBYL 20 YEARS AFTER
5. Kalinkovichi district, village Beryozovka
The density of contamination of territory by Cs-137 – 4,49 Ci/km2, dose of external
irradiation – 0,2 mSv/a, population – 421 people (120 schoolboys, in kindergarten – 25
children), quantity of measurements on April 19, 2001 – 47.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Beryozovka of Kalinkovichi district of Gomel region (19.04.01)
2
7
under 20 Bq/kg
12
20-70 Bq/kg
70-200 Bq/kg
more than 200
Bq/kg
26
6. Kalinkovichi district, village Slobodka
The density of contamination of territory by Cs-137 – 3,79 Ci/km2, dose of external
irradiation – 0,2 mSv/a, population – 166 people (no school and kindergarten), quantity of
measurements on January 27, 2000 – 76.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Slobodka of Kalinkovichi district of Gomel region (27.01.00)
8
2
22
under 20 Bq/kg
20-70 Bq/kg
70-200 Bq/kg
more than 200
Bq/kg
44
213
ECRR 2006: CHERNOBYL 20 YEARS AFTER
7. Korma district, village Klyapin
The density of contamination of territory by Cs-137 – 6,3 Ci/km2, dose of external
irradiation – 0,3 mSv/a, population – 88 people (49 schoolboys and no kindergarten),
quantity of measurements on December 7, 2001 – 50.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Klyapin of Korma district of Gomel region (07.12.01)
11
10
20-70 Bq/kg
70-200 Bq/kg
more than 200
Bq/kg
29
8. Korma district, village Litvinovichi
The density of contamination of territory by Cs-137 – 7,78 Ci/km2, dose of external
irradiation – 0,4 mSv/a, population – 1232 people (280 schoolboys and 44 children in
kindergarten), quantity of measurements on September 12, 2001 – 285.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Litvinovichi of Korma district of Gomel region (12.09.01)
14
4
under 20 Bq/kg
108
20-70 Bq/kg
159
70-200 Bq/kg
more than 200
Bq/kg
214
ECRR 2006: CHERNOBYL 20 YEARS AFTER
9. Lelchitsy district, village Dzerzhinsk
The density of contamination of territory by Cs-137 – 3,95 Ci/km2, dose of external
irradiation – 0,2 mSv/a, population – 1116 people (190 schoolboys and 100 children in
kindergarten), quantity of measurements on January 26, 1999 – 223.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Dzerzhinsk of Lelchitsy district of Gomel region (26.01.99)
8
1
under 20 Bq/kg
108
20-70 Bq/kg
70-200 Bq/kg
more than 200
Bq/kg
106
10. Lelchitsy district, village Glushkovichi
The density of contamination of territory by Cs-137 – 2,19 Ci/km2, dose of external
irradiation – 0,1 mSv/a, population – 2349 people (489 schoolboys and 140 children in
kindergarten), quantity of measurements on October 24, 2001 – 150.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Glushkovichi of Lelchitsy district of Gomel region (24.10.01)
1
29
36
under 20 Bq/kg
20-70 Bq/kg
70-200 Bq/kg
more than 200
Bq/kg
84
215
ECRR 2006: CHERNOBYL 20 YEARS AFTER
11. Narovlya district, village Verbovichi
The density of contamination of territory by Cs-137 – 19,44 Ci/km2, dose of external
irradiation – 0,9 mSv/a, population – 396 people (58 schoolboys and 13 children in
kindergarten), quantity of measurements on November 27, 2001 – 87.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Verbovichi of Narovlya district of Gomel region (27.11.01)
15
20-70 Bq/kg
46
70-200 Bq/kg
26
more than 200
Bq/kg
12. Narovlya district, village Golovchitsy
The density of contamination of territory by Cs-137 – 9,44 Ci/km2, dose of external
irradiation – 0,6 mSv/a, population – 522 people (139 schoolboys and 25 children in
kindergarten), quantity of measurements on November 28, 2001 – 160.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Verbovichi of Narovlya district of Gomel region (28.11.01)
27
24
under 20 Bq/kg
20-70 Bq/kg
70-200 Bq/kg
56
53
more than 200
Bq/kg
216
ECRR 2006: CHERNOBYL 20 YEARS AFTER
13. Narovlya district, village Demidov
The density of contamination of territory by Cs-137 – 10,38 Ci/km2, dose of external
irradiation – 0,5 mSv/a, population – 311 people (81 schoolboy and 22 children in
kindergarten), quantity of measurements on November 13-14, 2001 – 128.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Demidov of Narovlya district of Gomel region (13-14.11.01)
4
34
under 20 Bq/kg
20-70 Bq/kg
41
70-200 Bq/kg
more than 200
Bq/kg
49
14. Narovlya district, village Kirov
The density of contamination of territory by Cs-137 – 17,39 Ci/km2, dose of external
irradiation – 0,8 mSv/a, population – 424 people (89 schoolboy and 20 children in
kindergarten), quantity of measurements on November 28, 2001 – 100.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Kirov of Narovlya district of Gomel region (28.11.01)
41
22
20-70 Bq/kg
70-200 Bq/kg
more than 200
Bq/kg
37
217
ECRR 2006: CHERNOBYL 20 YEARS AFTER
15. Chechersk district, village Belyaevka
The density of contamination of territory by Cs-137 – 6,12 Ci/km2, dose of external
irradiation – 0,3 mSv/a, population – 436 people (70 schoolboy and 15 children in
kindergarten), quantity of measurements on February 11, 1999 – 58.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Belyaevka of Chechersk district of Gomel region (11.02.99)
14
22
20-70 Bq/kg
70-200 Bq/kg
more than 200
Bq/kg
22
16. Chechersk district, village Polesye
The density of contamination of territory by Cs-137 – 5,7 Ci/km2, dose of external
irradiation – 0,3 mSv/a, population – 566 people (137 schoolboy and 29 children in
kindergarten), quantity of measurements on October 24, 2001 – 114.
Diagram of distribution on intervals of specific activity of radionuclides in organism of
inhabitants of village Polesye of Chechersk district of Gomel region (24.10.01)
31
35
20-70 Bq/kg
70-200 Bq/kg
more than 200
Bq/kg
48
218
219
11
,0
9,
98
25
,1
0,
98
26
,0
3,
99
28
,0
4,
99
25
,0
5,
99
27
,1
0,
99
17
,1
1,
99
19
,0
4,
00
18
,0
5,
00
29
,1
1,
00
10
,0
1,
01
30
,1
0,
01
28
,1
1,
01
03
,0
5,
02
24
,0
5,
02
17
,1
0,
02
26
,1
1,
02
02
,1
0,
03
11
,1
1,
03
10
,0
3,
04
20
,0
5,
04
Average specific activity, Bq/kg
Date of measurement
17
,1
2,
03
03
03
66.8
18
,1
1,
03
02
02
02
02
109.9 96.8 78.9
22
,0
5,
17
,0
4,
11
,0
6,
24
,0
5,
16
,0
4,
02
01
350
300
250
200
150
100
50
0
13
,0
3,
22
,0
1,
27
,1
1,
Average specific activity,
Bq/kg
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Dynamics of change of average specific activity of radionuclides
of Cs-137 in organisms of children in village Verbovichi
316.7
153.3 112.5
221.6
154.05
59.6
Date of measurement
120
100
80
60
40
20
0
ECRR 2006: CHERNOBYL 20 YEARS AFTER
331.6
350
300
250
200
150
100
50
0
316.7
218.7
185.6
124.6
110.3
03
02
22
,0
5,
02
19
,1
2,
02
15
,1
1,
02
11
,0
6,
02
23
,0
5,
02
18
,0
4,
02
13
,0
3,
01
23
,1
1,
03
167
79.5
84.6
18
,0
6,
215.6
28
,1
1,
Average specific activity, Bq/kg
Dynamics of change of ave rage spe cific activity of radionuclide s of
Cs-137 in organism of childre n of village Kirov
Date of measurement
Average specific activity, Bq/kg
Reduction of levels of specific activity of Cs-137 in organism of children after
application of "Vitapect" and "Placebo"
35
30
25
20
15
10
5
0
1st measurement
2nd measurement
Measurement
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
normotonic
hypotonic
84.8
90
Percentage from inspected children,
%
hypertensive
80
67.7
70
60
50
50
40
40
25.8
30
20
9.1
10
6.1
10
6.5
0
Group 1 (0 Bq/kg)
Group 2 (38 Bq/kg)
Group 3 (122 Bq/kg)
Dynamics of ECG at diffe re nt le ve ls of accumulation of C s137 in organism of 543 childre n, inspe cte d in villages of
contaminate d districts of Be larus in 2003
Quantity of ECG at
children(%)
100
Normal ECG
ECG modifications
80
60
40
20
0
0-30 (n=169)
30-70 (n=195)
> 70 (n=179)
Conte nts of Cs-137 in organism of childre n (Bq/kg)
CHANGE-TYPE OF VASCULAR REACTION TO THE LOAD FOR
CHILDREN with AVERAGE SPECIFIC ACTIVITY OF CESIUM - 137
221
ECRR 2006: CHERNOBYL 20 YEARS AFTER
222
ECRR 2006: CHERNOBYL 20 YEARS AFTER
223
ECRR 2006: CHERNOBYL 20 YEARS AFTER
224
ECRR 2006: CHERNOBYL 20 YEARS AFTER
225
ECRR 2006: CHERNOBYL 20 YEARS AFTER
226
ECRR 2006: CHERNOBYL 20 YEARS AFTER
CHAPTER 13
Studies of Pregnancy Outcome Following the Chernobyl Accident
Alfred Korblein
Untere Soeldnersgasse 8, D-90403 Nuremberg, Germany
[email protected]
Perinatal mortality annual data from Germany and Poland show significant increases in
1987, the year following the Chernobyl accident, relative to the long term trend. In an
analysis of German monthly perinatal mortality data, peaks of perinatal mortality in the
beginning and at the end of 1987 are found. Both peaks are associated with peaks of the
caesium burden in pregnant women 7 months earlier (95% CI: 5.5 to 8.5 months). Infant
mortality monthly data from Poland exhibit the same pattern. The association with the
delayed caesium concentration is highly significant. A combined regression of early
neonatal mortality data from Germany and infant mortality data from Poland finds a
curvilinear dose response relationship with an estimated power of dose of 2.8 ± 0.8.
The perinatal mortality rate in Gomel, the most contaminated region of Belarus, is
compared with the rate in the rest of Belarus. The rates do not differ significantly until 1988
but then the rate in Gomel rises and reaches a 30% increased level in the 1990’s. This
increase can be explained as a late effect of the strontium uptake.
In February 1987, a significant 11.4% drop of birth rate is observed in Bavaria which might
be explained by an increased rate of spontaneous abortions immediately after Chernobyl
when the radiation intensity was highest. The health effects reported here all show a
temporal correlation with the radiation exposure from Chernobyl. According to
conventional radiobiological knowledge, no teratogenic effects are expected to occur below
a threshold dose of about 100 mSv. Even in the most contaminated regions of Germany,
however, the extra doses to the foetus were below 1 mSv in the first follow-up year.
Therefore the results contradict the widely accepted concept of a threshold dose for
radiation damage during foetal development.
1 Background
The observation of pregnancy outcome is a sensitive tool to detect possible adverse health
effects on human populations exposed to ionising radiation or other toxic agents. Adverse
pregnancy outcomes can be spontaneous abortions, congenital malformations, or perinatal
deaths. While perinatal mortality data are available in most countries, there are few
registers of congenital malformations, and most registers are incomplete. The European
register of congenital malformations EUROCAT covers only about 10% of the European
population.
The nuclear accident in Chernobyl on April 26, 1986, was the most severe
accident during the civil use of nuclear power. Large parts of Europe were contaminated by
the radioactive isotopes of iodine and caesium; strontium and plutonium were also recorded
nearer to the Chernobyl site. For radiobiologists and epidemiologists, the Chernobyl
accident offered a unique chance of studying the effects of low level ionising radiation on
the health of the general population. But the consequences of the Chernobyl disaster are
still under debate. The only generally accepted health effect of the Chernobyl accident is a
dramatic rise of thyroid cancers in Belarus, Ukraine and parts of the Russian Federation.
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Few studies are published in peer reviewed journals on the effects of Chernobyl on
perinatal mortality or stillbirth rates. Some of the papers are descriptive reports; precise
quantitative results (p-values and confidence intervals) are rather rare. In most cases
negative findings are reported, as a rule without mentioning the statistical power of the
studies.
In Finland, no significant increase of malformations rates or perinatal deaths was
found [1]. In West Germany, an upward deviation from an exponentially falling trend of
early neonatal mortality was reported after Chernobyl in Bavaria and Baden-Wuerttemberg,
the German Federal States with the highest radiation exposure [2]. But the result depended
on the extrapolation model used and was suspected to be an artefact [3]. In Norway, there
was an increase of spontaneous abortions for pregnancies conceived during the first 3
months after the Chernobyl accident [4]. Likewise, a 7.2% decrease of birth rate in
February 1987 was found in Italy [5]. In Hungary, no increase of congenital abnormalities
was observed after the Chernobyl accident, but again, the rate of live births decreased 9
months after May and June 1986 [6]. In the English counties of Cumbria, Clwyd and
Gwynedd, where there was heavy rainfall during the passage of the radioactive cloud, no
rise of perinatal mortality rates relative to the rest of the country was observed [7]. In a
review article about congenital anomalies and other reproductive outcomes the author
concludes that there is no consistent evidence of a detrimental physical effect of the
Chernobyl accident on congenital anomalies [8]. An increase in unfavourable pregnancy
outcome, including a rise of perinatal mortality, was observed in two heavily polluted
districts near the Chernobyl reactor site [9]. In Sweden, no change in the rate of
spontaneous abortions or congenital malformations occurred in pregnancies exposed at the
time of the accident [10]. In Kiev, no pronounced change of perinatal mortality rates was
observed after Chernobyl [11].
An increase of developmental abnormalties was found in 5-12 week old human
embryos in Belarus after Chernobyl [12]. Also in Belarus, neonates born in heavily
contaminated areas were apparently at risk for developing anaemia, congenital
malformations and perinatal death [13]. In a review article Goldman states that no
significant adverse medical effects other than thyroid cancers in children have been
reported in the populations affected by the Chernobyl accident [14]. In Germany,
malformation rates [15] and perinatal mortality rates [16] after Chernobyl in the higher
polluted southern part of the State of Bavaria were compared to the rates in the less polluted
northern part of Bavaria. No significant differences were found. The statistical power of the
study, however, was rather weak [17]. A trend analysis of German monthly perinatal
mortality rates found peaks that were associated with calculated peaks of caesium
concentration in the bodies of pregnant women 7 months earlier [18]. A persistent increase
of stillbirth rates after Chernobyl was reported for some eastern European countries outside
the former Soviet Union (Sweden, Poland, Hungary, Greece), while no increase was found
in central and western European countries [19]. In the State of Bavaria, excess stillbirth
rates in 1987 correlated with the level of fallout [20]. A similar study found no correlation
between fallout level and stillbirth rate in Finland [21]. In Belarus, perinatal mortality rates
in the region of Gomel, which experienced the highest fallout from Chernobyl, were
increased in the 1990's relative to the rates in the remainder of the country. The increase
was associated with the calculated strontium concentration in pregnant women [22].
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Figure 1: Perinatal mortality rates in Germany and long-term trend.
13
perinatal mortality rate per 1000
12
11
10
9
8
7
6
5
4
1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993
calendar years
The only official German study of perinatal mortality rates was conducted by the Federal
Office of Radiation Protection (Bundesamt für Strahlenschutz) [16]. Data from Bavaria
were chosen for this study because Bavaria is the German state that experienced the highest
fallout from Chernobyl. The population weighted caesium soil contamination was about 4times higher in southern Bavaria than in northern Bavaria. A possible radiation effect
should have changed the ratio of perinatal mortality in southern to northern Bavaria after
Chernobyl. However, the authors did not find any change in this ratio after Chernobyl. This
was perceived as evidence that there were no radiation effects from Chernobyl in Germany.
It can be shown, however, that the power of the study was too small to detect differences in
perinatal mortality rates below 30%. To find small effects, larger populations are needed.
This article is an overview of my studies about the effects of the Chernobyl fallout
on pregnancy outcome in Germany, Austria, Poland, Belarus, and Ukraine. To maximise
the statistical power of the studies, I included all available German data (80 million
population) rather than limiting the investigation to one German region (Bavaria, 11 million
population) as in [16]. With a trend analysis, the effects of short time perturbations are
investigated on the same population, so any confounding factors can be practically
excluded. The calculation of the long-term trend will be more precise as more data before
and after 1986, the year of the Chernobyl accident, are available.
2 Data
Perinatal mortality is the number of stillbirths plus early neonatal deaths (0-6 days), divided
by the number of live births plus stillbirths. Since in Germany the criteria for stillbirth
changed in 1980 and 1994, the study period was restricted to 1980-1993. In 1980, the
criterion for stillbirth changed from a body length of 35 cm to a birth weight of 1000 grams,
which again was changed to 500 grams in 1994.
German monthly perinatal mortality data, 1980-1993, were obtained from the German
Statistical Office (Statistisches Bundesamt). Monthly infant mortality data from Poland,
1985-1990, were supplied by the Institute of Mother and Child in
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Figure 2: Perinatal mortality rates in Poland and long-term trend.
perinatal mortality rate per 1000
19
18
17
16
15
14
13
12
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
calendar years
Warsaw. Perinatal mortality data and maternal age distributions from Belarus were
provided by the Statistical Department of the Belarus Ministry of Health in Minsk.
The caesium-137 soil contamination ranged from 2-3 kBq/m² in northern Germany to over
50 kBq/m² in southern Germany. Measured caesium concentrations in cows’ milk in
Munich, Germany, from May 1986 to December 1988, were provided by the state
supported Society for Environment and Health (Gesellschaft für Umwelt und Gesundheit,
GSF).
3 Annual data
Model
Perinatal mortality data are binary data, therefore the appropriate trend model is a logistic
regression model. A flexible form of the time dependency with a linear and a quadratic
term is used to describe the undisturbed long-term trend of the data. To test a possible
influence of the Chernobyl radiation on perinatal mortality in 1987, a dummy variable d87 is
used with d87=0 in all years except 1987 where d87=1. The model has the following form:
(3.1)
E(Y(t)) = 1/(1+1/exp(β1 +β2·t +β3·t² +β4·d87)).
Here E(Y(t)) is the estimated perinatal mortality rate, parameter β1 is the intercept, β2 and β3
estimate the linear and quadratic temporal trends, and β4 estimates the possible increase in
1987. A one-sided t-test is used to determine the significance of the excess perinatal
mortality rate in 1987 (hypothesis H0: β4 ≤ 0).
Results
Germany: A regression yields a good fit to German perinatal mortality data. The quadratic
term in the time dependency is highly significant (p=0.002, F-test). In 1987, there is a
significant 4.9% increase relative to the trend of all other years (p=0.0088). The excess rate
in 1987 is 0.36 per 1000 births that translates to 317 excess cases (95% CI: 67-578).
The increase of perinatal mortality in 1987 is essentially driven by a 7.4% increase
of early neonatal mortality rate (p=0.0035; 95% CI: 2.1% to 13.0%); the 2.9% increase of
stillbirth rate is not significant (p=0.100).
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Other countries: In the trend analysis of perinatal mortality rates from Poland, 1981-1991, a
linear logistic regression model is used. Again, the excess perinatal mortality rate in 1987 is
significant (p=0.0074). The excess rate is 0.57 per 1,000 births that translates to 354 excess
cases (95% CI: 89-626). About 75% of the excess perinatal deaths in 1987 are early
neonatal deaths.
A combined regression for Germany and Poland, with individual trend parameters
but a common parameter for the relative increase in 1987, yields a highly significant 4.2%
rise (p=0.0003).
The trends of perinatal mortality rates in Germany and in Poland are shown in
Figure 1 and Figure 2. The deviations from the trend, in units of standard deviations
(standardised residuals), are displayed in Figure 3.
In England and Wales no increase of perinatal mortality rates is observed in 1987 relative to
the trend of the data 1981-1992 (see Figure 4). The excess perinatal mortality rates in 1987
obtained from the regressions are listed in the following Table. The increase is greater in
Poland than in Germany, and greater in East Germany (former GDR) than in West
Germany.
Excess perinatal mortality rates 1987
data set
Poland
Germany
West Germany
East Germany
excess rate
0.572
0.363
0.247
0.623
% increase
3.8%
4.9%
3.5%
7.2%
excess cases
354
317
159
141
p-value*
0.0074
0.0088
0.0733
0.0279
* one-sided t-test
4 Monthly data
Model
A model for the trend of monthly data has to allow for seasonal variations of perinatal
mortality rates. Two periodic terms with periods of 12 and 6 months are therefore added to
model 3.1. Four additional parameters are needed, two for the amplitudes (β4, β6) and two
for the phase shifts (β5, β7):
(4.1)
E(Y(t)) = 1/(1+1/exp(β1 +β2·t +β3·t² +β4·cos(2π·(t-β5)) +β6·cos(2π·(2t-β7))))
The caesium concentration in cows’ milk is used as a proxy for the total internal
radiation exposure from caesium, essentially because data of caesium contamination in
cows’ milk were available. The caesium concentration in cow milk was measured nearly
every day at the Munich based GSF-Institute, from the beginning of May 1986 until the end
of 1988. In the first year following Chernobyl, the internal exposure of the German
population exceeded the external caesium exposure [23]. Milk produced in higher
contaminated southern Bavaria was distributed and consumed throughout West Germany.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Figure 3: Deviations between observed and expected rates in units of standard deviations
(standardised residuals) in Germany (black squares) and Poland (white squares). The
broken lines show the range of 2 standard deviations (2σ-range).
8
standardised residuals
6
Germany
Poland
4
2
0
-2
-4
-6
-8
1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993
calendar years
The calculation of the caesium concentration in pregnant women is based on the
assumption of a constant daily milk consumption and a somewhat shortened biological
half-life of caesium of 70 days during pregnancy. The caesium burden increases with
caesium uptake and decreases with caesium excretion. Figure 5 shows the measured
caesium concentration in milk (dots) and the calculated caesium burden in pregnant women
(solid line).
The regression model with the caesium term has the following form:
(4.2)
E(Y(t)) = 1/(1+1/exp(β1 +β2·t +β3·t² +β4·cos(2π·(t-β5)) +β6·cos(2π·(2t-β7)) +
β8·(cs(t-β10))^β9))
Parameter β8 estimates the size of the caesium effect, β10 is the time-lag between
caesium concentration cs(t) and perinatal mortality, and β9 is the power of dose which
allows for a curvilinear dose-response relationship.
To test the significance of the caesium term, the weighted sum of squares resulting from a
regression with the full model (4.2) is compared with the sum of squares obtained from a
regression without the caesium term (model 4.1). The F-test is applied where the F-value is
defined by
F = ((χ²0-χ²1)/(df0-df1))/(χ²1/df1).
Here χ²0 and χ²1 denote the weighted sum of squares under the null hypothesis and
under the full model, respectively; df0 and df1 are the corresponding degrees of freedom.
Here df0-df1 equals the number of parameters to be tested. The expression χ²1/df1 in the
denominator is the so called overdispersion factor. For a detailed description of the methods
see [18].
Perinatal mortality in Germany
German monthly perinatal mortality rates and the regression line are displayed in Figure 6.
Figure 7 shows the deviations of the observed rates from the calculated undisturbed trend
(standardised residuals) and the three-month moving average.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Figure 4: Perinatal mortality rates in England and Wales and long-term trend.
13
perinatal mortality rate per 1000
12
11
10
9
8
7
6
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
calendar years
400
40
350
35
300
30
250
25
200
20
150
15
100
10
50
5
0
caesium in humans [Bq per kg]
caesium in cow milk [Bq per l]
Figure 5: Caesium concentration in cows’ milk (short dashes) and in pregnant women
(solid line), calculated with a constant daily consumption of cow milk and a biological half
life of 70 days.
0
86
87
88
89
calendar years
There are significant peaks of perinatal mortality in the beginning and at the end of 1987.
A regression without the caesium term (model 4.1) yields a weighted sum of
squares of 221.6 (df=161). Regressions with model 4.2 are then performed with different
time-lags β10. The best fit with a sum of squares of 204.5 (df=158) is obtained for a timelag of 7 months. The corresponding F-test is significant (p=0.0053).
233
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In Figure 8, the profile sum of squares is plotted as a function of the time-lag. The
broken line gives an estimate of the 95% confidence interval from 5.5 to 8.5 months based
on the F-test.
Figure 6: Monthly perinatal mortality rates in Germany and regression line with
seasonal variations.
14
13
mortality rate per 1000
12
11
10
9
8
7
6
5
4
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
calendar years
Infant mortality in Poland
For Poland, monthly data were obtained only for infant mortality (death within the first year
of life) and for a relatively short period from 1985 to 1990.
Again, regressions without and with the caesium term are performed, using a timelag of 7 months as found in the German perinatal mortality data. The corresponding sums
of squares are χ² = 126.8 (df=65) and χ² = 99.1 (df=63). The corresponding F-test is highly
significant (p=0.0004, F-test). For time-lags of both 8 and 6 months, the sums of squares
are greater than for 7 months. Thus, like in the German data, 7 months is the best estimate
for the time-lag. Figure 9 shows the trend of the data and the regression line; Figure 10
displays the deviations of the observed data from the expected trend (standardised
residuals).
Combined regression
For a comparison of the effect size in Poland and Germany, early neonatal mortality data
from Germany were used because perinatal mortality also includes stillbirths. More than
50% of infant deaths in the first year of life actually occur within the first 7 days (early
neonatal deaths). To increase the precision of the parameter estimates, a combined
regression with individual parameters for the long-term trend and common parameters for
the seasonal components and the caesium term is performed.
The sum of squares resulting from the combined regressiom is 356.8 (df=230)
without and 310.5 (df=228) the caesium term. The corresponding F-test is highly
significant (p<0.0001). For time-lags of 6 as well as 8 months, the weighted sums of
squares are significantly greater than for 7 months (319.0 and 337.8, respectively).
The best estimate of the power of dose is β12 =2.8 ± 0.8. With a linear dose
response model, i.e. β12=1, the sum of squares increases significantly to 321.3 (df=229).
The corresponding F-test yields p=0.0052, i.e., the dose dependency is curvilinear.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Figure 7: Deviations of monthly perinatal mortality rates in Germany from the undisturbed
trend of the data (standardised residuals). The solid line is the three-month moving average,
the broken lines show the 2σ-range.
8
standardised residuals
6
4
2
0
-2
-4
-6
-8
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
calendar years
5 Belarus
The region (oblast) of Gomel was the area with highest fallout in Belarus. The strontium
soil contamination in parts of Gomel oblast outside the 30-km exclusion zone exceeded
37,000 Bq/m² in 1986 (see Figure 11) whereas in Munich little strontium was determined in
the Chernobyl fallout (210 Bq/m² Sr-90 compared to about 20,000 Bq/m² Cs-137, May
1986),
The trend of perinatal mortality rates, 1985-1998, in the oblasts of Gomel, MinskCity, and in Belarus minus Gomel and Minsk-City, are displayed in Figure 12. In 1994
there is a 20% increase of perinatal mortality in all three data sets which is the consequence
of a definition change for stillbirth.
Perinatal mortality data from the City of Minsk do not conform with the data in the
rest of Belarus. The rates from Minsk-City are consistently higher than in the rest of
Belarus until after 1995 when they suddenly drop by 50%. No such decrease occurs in the
other regions of Belarus, i.e. the peculiarity in the City of Minsk, the capital of Belarus, is
not likely to have biological reasons. Therefore the data for the City of Minsk are omitted
when perinatal mortality rates in Gomel oblast (study area) are compared to the rates in the
rest of Belarus (control area).
A trend analysis of perinatal mortality data is problematic for two reasons. First –
as in most European countries - the definition of stillbirth was changed at the end of 1993.
Second, possible socio-economic problems after the break-up of the Soviet Union in 1991
might have had an influence on the trend of perinatal mortality rates. Assuming that these
influences acted equally in the study and the control region, a possible effect of radiation
exposure should be found in the ratio of perinatal mortality rates in Gomel oblast to the
rates in the control area.
Method
The ratio of perinatal mortality rate p1 in Gomel to the rate p0 in the control area can be
expressed by the odds ratio (OR) which is defined by
OR = (p1/(1-p1)) / (p0/(1-p0)).
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Figure 8: Sums of squares as a function of the time-lag between caesium concentration in
pregnant women and perinatal mortality in Germany (profile likelihood). The broken line
indicates the 95% confidence interval for the time-lag.
weighted sum of squares
225
220
215
210
205
200
0
1
2
3
4
5
6
7
8
9
10
time-lag [months]
A weighted regression of the logarithms of the odds ratios is performed with the model
(5.1)
ln(OR) = ln(1 +β0 +β1·d87 +β2·sr(t))
where parameter β0 allows for a difference in the base line perinatal mortality rates in the
study and the control area, β1 estimates a possible caesium effect in 1987 (dummy variable
d87) and β2 estimates the possible effect of strontium on the data.
The expression sr(t) is the average strontium concentration in pregnant women calculated
under the assumption that strontium is mainly incorporated at the end of the period of
menarche, the time of maximum bone growth, at about age 14 [25].
Figure 9: Monthly infant mortality rates in Poland from 1985 to 1990 and regression line.
The dotted line is the undisturbed long-term trend.
Infant mortality rate per 1000
25
20
15
10
5
0
85
86
87
88
89
90
91
calendar years
For a given year following Chernobyl, the average strontium concentration is approximated
by the percentage of pregnant women who were 14 years old in 1986, i.e., who were born
in 1972. This percentage follows from the maternal age distribution. In Belarus, maternal
age distributions were only available in 5 year strata. The shaded area in Figure 13 is the
236
ECRR 2006: CHERNOBYL 20 YEARS AFTER
average age distribution in Belarus for 1992-1996. To get approximated annual values, a
superposition of two lognormal distributions was used to fit the step function (solid line in
Figure 13).
Second, the strontium excretion from the body must be considered in the calculation of
sr(t). According to the ICRP Publication 67 [26], the strontium excretion cannot be
described by a simple exponential decrease, but is composed of a fast and a slow
component. Thus, the strontium term sr(t) in year t after Chernobyl has the form
sr(t) ~ F(t-1972)·(A1·exp(-ln(2)·(t-1986)/T1)+A2·exp(-ln(2)·(t-1986)/T2))
where F(t-1972) is the fraction of pregnant women born in 1972. T1=2.4 years and T2=13.7
years are effective half-lives of strontium in the female body. The constants A1, A2 and the
half-lives T1, T2 were determined from a regression of tabulated values given in [27].
For the regression the data are population weighted with weights
(5.2)
σ² = 1/n1 + 1/(N1-n1) + 1/n0 + 1/(N0-n0)
where n1 and n0 are the number of perinatal deaths in the study(1) and control(0) area and
N1, N0 the corresponding numbers of live births plus stillbirths.
To test the significance of the parameters, two-sided t-test are applied (H0: β2=0, β3=0).
Figure 10: Deviations of observed infant mortality rates from Poland (dots) from the
undisturbed trend (standardised residuals). The solid line is the three-month moving
average, the broken lines show the 2σ-range.
8
standardised residuals
6
4
2
0
-2
-4
-6
-8
85
86
87
88
89
90
91
calendar years
Results
To determine the age of maximum strontium uptake from the data, regressions with
strontium terms for maximum strontium uptake at age 13, 14, and 15 are performed. The
results for the sums of squares are 9.7, 7.3 and 9.9, respectively. Thus the strontium term
with an age of 14 years for maximum strontium uptake fits the data best.
The regression yields β0 = 0.022 ± 0.027, i.e., there is no appreciable difference in
perinatal mortality rates between study and control area before Chernobyl. Also, the
increase in 1987 is not significant (β1=0.055 ± 0.060).
Not only constant β2 but also the age of maximum strontium uptake was estimated from the
data therefore an F-test with two degrees of freedom is applied to determine the
significance of the strontium effect. The sum of squares is 29.7 (df=12) without and 7.3
(df=10) with the strontium term. The corresponding F-test is significant (p=0.0028).
Figure 14 shows the observed (dots) and expected odds ratios (solid line) resulting
from a regression with β0=0 (see equation 5.1). In the mid 1990’s the odds ratios are about
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
1.3, i.e., perinatal mortality rates in Gomel are 30% higher than in the control area. The
excess perinatal mortality rates in Gomel translate to 431 excess perinatal deaths, 19871998.
Figure 11: Strontium-90 soil contamination near the Chernobyl reactor site (from German
journal Atomwirtschaft, March 1991). The hatched areas indicate strontium concentrations
greater than 1 Ci/km² (37 kBq/m²) and 3 Ci/km² (111 kBq/m²), respectively. The circle is
the 30-km evacuation zone.
6 Spontaneous abortions in Bavaria
The most sensitive phase in embryonic development is before the first cell division, i.e.,
during the first hours after fertilisation. In this period an all or nothing rule holds, i.e., the
fertilised egg either survives without damage or is aborted. A possible increase of
spontaneous abortions will lead to a decrease of live births 9 months after exposure.
Bavaria was the German region with highest fallout. Figure 15 shows continuous
measurements of the activity in air 1 meter above ground in the Munich based GSF
Institute. Immediately after the Chernobyl accident the activity rose from 8 µR/h to about
110 µR/h. The number of live births plus stillbirths dropped significantly (p=0.0030) by
11.4% relative to the long-term trend in February 1987, nine months after May 1986. The
decrease is more pronounced in southern Bavaria (-13,4%, p=0.0005) than in northern
Bavaria (-8.7%, p=0.0370) and is limited to a single month. In March 1987, the number of
births returned to the expected level. Figure 16 shows the deviations of the monthly number
of live births plus stillbirths in southern Bavaria from the trend of the data, 1984-1989. The
estimated number of missing births in Bavaria in February 1987 is 1154. There might have
been fewer planned conceptions after the Chernobyl accident, but it does not seem plausible
that the fear of an adverse pregnancy outcome was limited to May 1986.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Figure 12: Perinatal mortality rates in Gomel, Minsk-City, and Belarus minus Gomel and
Minsk-City. The offset in 1994 results from a change in the definition of stillbirths.
perinatal mortality rate per 1000
18
16
14
12
10
Minsk
Gomel
Belarus minus Gomel and Minsk
8
6
85
86
87
88
89
90
91
92
93
94
95
96
97
98
calendar years
Figure 13: Maternal age distribution in Belarus, averaged for 1992-1996, and
interpolation curve using two superimposed lognormal distributions.
0,6
0,5
proportion
0,4
0,3
0,2
0,1
0,0
15
20
25
30
maternal age [years]
239
35
40
45
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Figure 14: Odds ratios of perinatal mortality in Gomel vs. Belarus minus Gomel and
Minsk-City, and regression line.
1,5
odds ratio
1,4
1,3
1,2
1,1
1,0
85
86
87
88
89
90
91
92
93
94
95
96
97
98
calendar years
Figure 15: Gamma dose rate in the air during May 1986 in Munich, Germany. In the
first days of May it reached about 110 µR/h, more than 10-times the normal level of 8
µR/h.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
Figure 16: Deviations of the monthly number of live births plus stillbirths from the longterm trend in southern Bavaria. The broken lines indicate the 2σ-range.
1200
excess number of births
800
400
0
-400
-800
-1200
84
85
86
87
88
89
90
calendar years
7 Discussion
A trend analysis finds significant increases of perinatal mortality in Germany and Poland in
1987, the year following the Chernobyl accident. The monthly data exhibit a significant
association between perinatal mortality and the delayed caesium concentration in pregnant
women. In Poland, which experienced a higher average fallout from Chernobyl than
Germany, the increase of perinatal mortality in 1987, as well as the caesium effect on
monthly infant mortality data, is greater than in Germany. No increase in 1987 is found in
perinatal mortality data from England and Wales.
In the region of Gomel, Belarus, a significant association of perinatal mortality
with the calculated strontium burden in pregnant women is found. The method used to
calculate the strontium burden had already been successfully used in a trend analysis of
German perinatal mortality after the atmospheric nuclear weapons tests between 1952 and
1963 [28].
In Bavaria, a significant drop in birth rate is observed in February 1987, nine
months after the Chernobyl accident, which might well be the consequence of more
spontaneous abortions. Similar decreases in birth rate were observed in several other
European countries [4, 5, 6].
The findings provide evidence of adverse radiation effects to the foetus in the first
trimester of pregnancy and challenge the widely accepted concept of a threshold dose for
teratogenic effects. The foetus seems to be much more vulnerable to ionising radiation than
generally believed. The form of the dose response relationship, however, is not linear.
The results for Belarus and Ukraine cannot be understood with the present dose
factor for strontium. The doses from strontium in the contaminated regions as given in [29]
were less than 5% of the doses from caesium but the strontium effect on perinatal mortality
exceeded the caesium effect by at least a factor of 10.
The results should be interpreted with caution since they are based on aggregated data. But
as long as there is no other way to study small radiation effects in human populations, the
findings should not be dismissed for lack of an ultimate proof of causation.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
References
Harjulehto T, Aro T, Rita H, Rytomaa T, Saxen L. The accident at Chernobyl and outcome
of pregnancy in Finland. BMJ. 1989 Apr 15;298(6679):995-7.
Luning G, Scheer J, Schmidt M, Ziggel H. Early infant mortality in West Germany before
and after Chernobyl. Lancet. 1989 Nov 4;2(8671):1081-3.
Lancet. 1990 Jan 20;335(8682):161-2. Comment on: Lancet. 1989 Nov 4;2(8671):1081-3.
Infant mortality after Chernobyl. [No authors listed]
Ulstein M, Jensen TS, Irgens LM, Lie RT, Sivertsen E. Outcome of pregnancy in one
Norwegian county 3 years prior to and 3 years subsequent to the Chernobyl
accident. Acta Obstet Gynecol Scand. 1990;69(4):277-80.
Bertollini R, Di Lallo D, Mastroiacovo P, Perucci CA. Reduction of births in Italy after the
Chernobyl accident. Scand J Work Environ Health. 1990 Apr;16(2):96-101.
Czeizel AE. Incidence of legal abortions and congenital abnormalities in Hungary. Biomed
Pharmacother. 1991;45(6):249-54.
Bentham G. Chernobyl fallout and perinatal mortality in England and Wales. Soc Sci Med.
1991;33(4):429-34.
Little J. The Chernobyl accident, congenital anomalies and other reproductive outcomes.
Paediatr Perinat Epidemiol. 1993 Apr;7(2):121-51. Review.
Kulakov VI, Sokur TN, Volobuev AI, Tzibulskaya IS, Malisheva VA, Zikin BI, Ezova LC,
Belyaeva LA, Bonartzev PD, Speranskaya NV, et al. Female reproductive function
in areas affected by radiation after the Chernobyl power station accident. Environ
Health Perspect. 1993 Jul;101 Suppl 2:117-23.
Ericson A, Kallen B. Pregnancy outcome in Sweden after the Chernobyl accident. Environ
Res. 1994 Nov;67(2):149-59.
Buzhievskaya TI, Tchaikovskaya TL, Demidova GG, Koblyanskaya GN. Selective
monitoring for a Chernobyl effect on pregnancy outcome in Kiev, 1969-1989.
Hum Biol. 1995 Aug;67(4):657-72.
Laziuk GI, Kirillova IA, Dubrova IuE, Novikova IV. [Incidence of developmental defects
in human embryos in the territory of Byelarus after the accident at the Chernobyl
nuclear power station]. Genetika. 1994 Sep;30(9):1268-73. Russian.
Petrova A, Gnedko T, Maistrova I, Zafranskaya M, Dainiak N. Morbidity in a large cohort
study of children born to mothers exposed to radiation from Chernobyl. Stem
Cells. 1997;15 Suppl 2:141-50.
Goldman M. The Russian radiation legacy: its integrated impact and lessons. Environ
Health Perspect. 1997 Dec;105 Suppl 6:1385-91. Review.
Irl C, Schoetzau A, van Santen F, Grosche B. Birth prevalence of congenital malformations
in Bavaria, Germany, after the Chernobyl accident. Eur J Epidemiol. 1995
Dec;11(6):621-5.
Grosche B, Irl C, Schoetzau A, van Santen E. Perinatal mortality in Bavaria, Germany,
after the Chernobyl reactor accident. Radiat Environ Biophys. 1997 Jun;36(2):12936.
Scherb H, Weigelt E. Comment on: Radiat Environ Biophys. 1997 Jun;36(2):129-36. A
response to "Perinatal mortality in Bavaria, Germany, after the Chernobyl
accident" by Grosche et al. Radiat Environ Biophys. 1998 Feb;36(4):297-9.
Korblein A, Kuchenhoff H. Perinatal mortality in Germany following the Chernobyl
accident. Radiat Environ Biophys. 1997 Feb;36(1):3-7.
Scherb H, Weigelt E, Bruske-Hohlfeld I. European stillbirth proportions before and after
the Chernobyl accident. Int J Epidemiol. 1999 Oct;28(5):932-40.
242
ECRR 2006: CHERNOBYL 20 YEARS AFTER
Scherb H, Weigelt E, Bruske-Hohlfeld I. Regression analysis of time trends in perinatal
mortality in Germany 1980-1993. Environ Health Perspect. 2000 Feb;108(2):15965.
Auvinen A, Vahteristo M, Arvela H, Suomela M, Rahola T, Hakama M, Rytomaa T.
Chernobyl fallout and outcome of pregnancy in Finland. Environ Health Perspect.
2001 Feb;109(2):179-85.
Korblein A. Strontium fallout from Chernobyl and perinatal mortality in Ukraine and
Belarus. Radiats Biol Radioecol. 2003 Mar-Apr;43(2):197-202.
Paretzke H. Transfer von Nukliden. Mensch und Umwelt, Magazin des GSFForschungszentrums für Umwelt und Gesundheit, December 1986:39-48.
Korblein A. Infant Mortality in Germany and Poland following the Chernobyl accident.
Abstr 3rd Inter Conf on Health Effects of the Chernobyl Accident, 4-6 June, 2001,
Kiev, Ukraine. Int J Rad Med Special Issue Vol. 3 (1-2): 63.
Tolstykh E I, Kozheurov V P, Vyushkova O V, Degteva M O. Analysis of strontium
metabolism in humans on the basis of the Techa river data. Radiat Environ
Biophys 1997; 36: 25-29.
INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION (1993). Age
dependent doses to members of the public from intake of radionuclides: Part 2:
Ingestion dose coefficients. ICRP Publication 67, Annals of the ICRP 23, Nos. 34. Pergamon Press, Oxford.
INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION (2003).
Biological effects after prenatal irradiation (Embryo and Fetus). ICRP Publication
90, Annals of the ICRP 33, Nos. 1-2. Pergamon Press, Oxford.
Körblein A. Perinatal mortality in West Germany Following Atmospheric Nuclear
Weapons Tests, Arch Envrion Health, 2006, in print.
Environmental Consequences of the Chernobyl Accident and Their Remediation: Twenty
Years of Experience. Report of the UN Chernobyl Forum Expert Group
“Environment” (EGE), August 2005.
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
CHAPTER 14
First Assessment of the Actual Death Toll
Attributable to the Chernobyl Disaster Based Upon Conventional Risk
Methodology
By Dr. Rosalie Bertell
IICPH, Toronto
[email protected]
Introduction
The Chernobyl disaster was in 1986, and now, 20 years after the event, there is as yet no
comprehensive systematic report on the casualties. This paper presents an attempt to extend
the sketchy information given in UNSCEAR 2000 (United Nations Scientific Committee of
Atomic Radiation Report to the General Assembly in 2000)
to the entire population at
risk and estimate the fatalities due to the radiation damage to tissue and/or its ability to
initiate a fatal cancer. Many of the estimates are, of their nature, speculative, and the true
estimate is most likely higher than this attempt at quantification for reasons given below.
Earlier attempts have been undertaken, especially notable among them the one by Dr. John
Gofman:
My estimate in 1986, based upon releases of various non-iodine radionuclides,
was 475,000 fatal cancers plus about an equal number of additional non-fatal
cases, occurring over time both inside and outside the ex-Soviet Union. Such
estimates, old and new, have to be based on real-world evidence from nonChernobyl studies --- because standard epidemiological studies (which "count"
extra cancer cases) are the wrong tool for evaluating Chernobyl. No one can "see"
even a half-million Chernobyl-induced cancers when they are spread among a
half-billion people and occur over a century.[“Don’t be Fooled: 10th Anniversary
of Chernobyl”, Dr. John Gofman, 9 March 1996]
This limited focus on deaths attributable to Chernobyl causes the many related tragedies of
survivors to be ignored. This is especially regrettable for those many children who
developed heart disease and thyroid cancers or other dysfunctions.
According to Table 1 (UNSCEAR 2000, Annex J, page 518) there were 46
radionuclides of note in the Chernobyl reactor inventory at the time of the accident. About
26 of these radionuclides were released into the air at the time of the disaster (Table 2, page
519). Of these, 17 were found in the near zone of the failed reactor (Table 6, page 521). It is
important to note that the ceramic aerosolized uranium fuel particles, similar to those which
have caused at least some of the devastating symptoms of the Gulf War Syndrome, were
ignored in. both Table 2 and Table 6. Only radioactive cesium was used in UNSCEAR
2000 as a basis for determining the external effective radiation doses to the larger exposed
population.
Information on radioactive iodine exposures is given by UNSCEAR 2000.
However, since about 95% of thyroid cancers can be survived, this tragedy is not dealt with
in these death estimates. Important research on radiation related heart disease in Belarus
was unfortunately interrupted, and also is not included in UNSCEAR 2000.
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Death due to Radiation:
The very early deaths due to radiation are those who suffered severe damage to the Central
Nervous System. They die quickly, and are undoubtedly the 23 deaths that UNSCEAR
2000 attributes to the acute radiation syndrome deaths in the Moscow Hospital. Deaths due
to severe exposure of the lung tissue and the red bone marrow would be expected to occur
over the two years following. Given the lung and bone marrow doses in Table 14 (page
524) and the fact that 713 emergency workers (87% of 820, Table 17, page 525) had
external effective doses of radiation above 0.5 Sv, I have estimated 140 deaths due to lung
irradiation and 90 deaths due to bone marrow irradiation. Thus, I would estimate deaths
attributable to radiation as: 290.
Estimated Fatal Cancers among Emergency & Recovery Workers, and the Population
Evacuated and Not-evacuated from the Highly Contaminated Zones:
Emergency and Recovery Workers and accident Witnesses, were exposed to both external
and internal radiation during the disaster. The estimated fatal cancer risks were based on
external doses, given in Tables 16 and 17 (page 225). Cancer deaths were estimated using
10%/Person Sv, from UNSCEAR 1991 and BEIR V (U.S. National Academy Biological
Effects of Ionizing Radiation) reports using the DS 86 dosimetry from Hiroshima and
Nagasaki. A higher 20%/Person Sv estimate is based on the cancer risks noted in the work
of Drs. John Gofman, Alice Stewart and Steve Wing, who posit risks as high as 30 to 50%
per Person Sv. A risk of 20%, as used in this paper, is clearly within a reasonable
probability margin of the official estimate.
Cancer deaths of Emergency and Recover Workers in 1986 are estimated to be
1,407 to 2,813. These workers undoubtedly suffered inhalation and ingestion exposure due
to air contamination, and food/water contamination. Based on Table 53 (page 541), I
assumed that the internal dose was about 76% of the external dose. This gives an estimate
of 1,069 to 2,138. Therefore, the estimate of cancer deaths among the emergency and
rescue workers was 2,476 to 4,951. No data on the Accident Witnesses is given,
contributing to the conservativeness of this estimate.
Estimate of Cancer Deaths in the Former U.S.S.R.
Table 24 (page 528) gives the distribution of doses from external radiation of the evacuees
from “areas of strict control” in Belarus. The evacuated population would be expected to
have 70 to 140 cancer deaths, while those not evacuated would have 251 to 502 cancer
deaths. The total number of people evacuated from the “areas of strict control” was
116,317. If those other 78.8% of evacuees had roughly the same experience as those in
Belarus, their external exposure would have resulted in 260 cancer deaths. If the nonevacuated population was proportional to that in Belarus, they would have experienced 936
to 1872 cancer deaths. The UNSCEAR data failed on many scores to provide the basic
information on these radiation refugees. In total, the expected cancer deaths among those
in the “areas of strict control” (the most contaminated areas, was 1,517 to 3,034.
The cancer death estimate due to external irradiation of the former U.S.S.R.
contaminated, but not controlled areas, using Table 53 (page 541) was 4,260 to 8,520. This
population has received an internal radiation dose from contaminated food and water since
1986, although UNSCEAR 2000 provided no information on food and water
contamination. Having no guidance from UNSCEAR 2000, I will assume that this 20 years
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
of internal irradiation dose is about 76% of the immediate external radiation dose.
Therefore the cancer deaths from internal radiation exposure would be about 3,238 to
6,475, given a total cancer death toll of 7,498 to 3,034.
It must be emphasized that this estimate assumes that the internal dose can be safely
modeled on the basis that its effects can be predicted using the external acute exposure
risk model derived from the Japanese A-Bombs. This assumption is not likely to be
true for many of the isotopes involved due to anisotropy of exposure, and for this
reason, the true yield from internal irradiation is likely to be some two orders of
magnitude higher. The matter has been discussed by the European Committee on
Radiation Risk ECRR2003 report. I
Estimated Cancer Deaths in Europe Due to the Chernobyl Disaster:
For five European countries, Croatia, Greece, Hungary, Poland and Turkey, no estimate of
radiation exposure was given except for radioactive iodine dose to the thyroid. It is obvious
that these countries also suffered direct external irradiation from fallout and contamination
of their food and water. I have no estimates for these exposures. Eight countries, Belarus,
Finland, Germany (Bavaria), Greece, Hungary, Romania, Sweden and Turkey (Black Sea
Coast and Edime Province), had estimated absorbed dose given in mGy, seemingly for an
epidemiological study of leukemia. Since it was a matter of leukemia, it would be normal to
asses the dose to red bone marrow. No conversion of mGy to mSv was given, and the
proportions of alpha (RBE 20) or beta (REB 1.7) radiation were not given. Assuming that
they only calculated external radiation dose due to radioactive cesium, and based on their
1986 population, this European subgroup will be expected to have 1,517 to 3,034 cancer
deaths. If we include the whole population of Europe in 1986 and assume 1 mSv effective
dose per person to all not in this subgroup, from the Chernobyl fallout, we can estimate
887,819 to 1,775,638 fatal cancers. Any over estimation would be compensated for by the
exclusion of consideration of contaminated food and water. The conservative estimate of
cancer fatalities in Europe attributable to Chernobyl is 889,336 to 1,778,672.
Summary:
Using conservative methodology based on the external radiation risk factors deduced from
the Japanese A-Bomb studies, I would estimate that the eventual death toll from the
Chernobyl disaster would be:
290 due to direct radiation damage
899,310 to 1,786,657 due to fatal cancers
899,600 to 1,787,000 in total
To repeat, this estimate is conservative for several reasons, firstly, because of the
failure of the radiation investigation to document the extent of radiation
contamination of food, and the absence of a comprehensive scientific examination of
all deaths among the emergency and rescue workers and other populations exposed.
The researchers appear to have relied on elimination of all cancers occurring in the
first ten years after the accident, and a rough estimate (using a minimal risk factor
reduced by a DDRF) for estimating cancer deaths. It is well known that radiation,
through its mutation ability, can accelerate the development of any cancers present in
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ECRR 2006: CHERNOBYL 20 YEARS AFTER
the population at the time of the disaster. Many early, uncounted cancers may fit into
this category.
Again, there is also currently a scientific dispute about the acceptability of the ICRP
(International Commission on Radiation Protection) methodology for assessing
internal dose, especially from ceramic aerosol nuclear fuel particles, and for certain
internal nuclides which bind to DNA as articulated by the ECRR (European
Committee on Radiation Risk) and now accepted by the IRSN radiation protection
committee in France. These particles do not spread homogeneously in the internal
organs and anisotropy of dose can be very great. The UNSCEAR 2000 analysis
ignored these considerations in their analysis. When this scientific effort develops an
acceptable alternative to ICRP methodology, we may be able to adjust this estimate of
cancer death accordingly.
Clearly, the true damage to health attributable to the Chernobyl disaster has been
kept from the general public through poor and incomplete scientific investigation.
248
ECRR 2006: CHERNOBYL 20 YEARS AFTER
The European Committee on Radiation Risk ECRR
Greta Bengtsson
The European Committee on Radiation Risk was formed in 1997 following a
resolution made at a conference in Brussels arranged by the Green Group in the
European Parliament. The meeting was called specifically to discuss the details of
the Directive Euratom 96/29, now known as the Basic Safety Standards Directive.
This document had been passed by the Council of Ministers without significant
amendment by the Parliament, and contained a statutory framework for the
recycling of radioactive waste into consumer goods so long as the concentrations of
itemised radionuclides were below certain levels.
The Greens, who had attempted to amend the draft with only limited
success, were concerned about the lack of democratic control over such an
important issue and wished for some scientific advice regarding the health effects
which might follow the recycling of man-made radioactivity. The feeling at the
meeting was that there was considerable disagreement over the health effects of
low-level radiation and that this issue should be explored on a formal level. To this
end the meeting voted to set up a new body which they named The European
Committee on Radiation Risk. The remit of this group was to investigate and
ultimately report on the issue in a way that considered all the available scientific
evidence. In particular, the Committee’s remit was to make no assumptions
whatever about preceding science and to remain independent from the previous
risk assessment committees such as the International Commission on Radiological
Protection (ICRP), the United Nations Scientific Committee on the Effects of
Atomic Radiation (UNSCEAR), the European Commission and risk agencies in
any EU member State.
The ECRR's remit is:
1. To independently estimate, based on its own evaluation of all scientific
sources, in as much detail as necessary and using the most appropriate
scientific framework, all of the risks arising from exposure to radiation, taking
a precautionary approach.
2. To develop the best scientific predictive model of detriment following
exposure to radiation, presenting observations which appear to support or
challenge this model, and highlighting areas of research which are needed to
further complete the picture.
3. To develop an ethical analysis and philosophical framework to form the basis
of its policy recommendations, related to the state of scientific knowledge,
lived experience and the Precautionary Principle.
4. To present the risks and the detriment model, with the supporting analysis, in a
manner to enable and assist transparent policy decisions to be made on
radiation protection of the public and the wider environment.
The committee now has more than 50 experts from many countries collaborating
on the issue of radiation risk and has set up a mumber of sub-committees and
groups. The committee’s risk model was presented in 2003 in Brussels and is
249
ECRR 2006: CHERNOBYL 20 YEARS AFTER
published as the ECRR2003 Recommendations: the Health effects of Ionising
Radiation Exposure at Low Dose for Radiation Protection Purposes (ISBN
1897761 24 4). The report, now in its second printing, has been widely circulated
and translated and published in French, Russian, Spanish and Japanese. The price
of the English edition is £45 with a concession price of £15 for students/ NGOs. It
is available by order from any bookseller or direct by emailing an order
[email protected]
The ECRR is increasingly being consulted by government groups, most
recently by the UK government Committee on Radioactive Waste Management
(CORWM) who have asked ECRR to collaborate on a waste management health
impact assessment.
The risk model presented in ECRR2003 is in accord with the evidence of
increases in cancer and other ill health in areas or groups exposed to low dose
radiation. Recent reports of increases in cancer in Sweden (published by Martin
Tondel et al. (2004) or the 300% increases in breast cancer reported for Belarus by
the IARC researchers and, indeed, the increases in ill health shown in the present
volume, are all explained or predicted by the committees model. The model also
explains the increases in cancer caused by the atmospheric weapons fallout
exposures of the 1960s (Busby 1994, 2002). The volume is essential reading for
anyone involved in legislation in this area or who wants to obtain a realistic and
rationally based set of rules to calculate the outcome of past and future exposures.
The ECRR welcomes scientists to join its group or to comment or make
suggestions. Contact Greta Bengtsson at [email protected]
References
Busby C C (1994) Increase in cancer in Wales unexplained’ British Medical
Journal 308 268.
Busby C C (2002) ‘High risks at low doses’ Proceedings of the 4th International
Conference on the Health Effects of Low Dose Radiation; Oxford Sept 24 2002
London: British Nuclear Energy Society
Pukkala E. et al., (2006) Breast Cancer in Belarus and Ukraine After the Chernobyl
Accident. Int. J. Cancer, 27th February.
www3.interscience.wiley.com/doi:10.1002/ijc.21885
Tondel M, Hjalmarsson P, Hardell L, Carlsson G and Axelson O (2004) Increase in
regional total cancer incidence in North Sweden due to the Chernobyl accident
J.Epid. Commun. Health 58 1011-1016
250
The Chernobyl accident contaminated large parts of the Soviet Union and
Europe. Radioactivity was ultimately detected everywhere in the northern
hemisphere. Doses to the emergency workers from external gamma-rays
and internal fission-product radionuclides were significantly high, many
died at the time. 20 years later, many liquidators still die and all are ill. The
radionuclide contamination of the environment was significant and longlasting. This resulted in chronic internal low dose exposure to millions of
people, to animals and plants. Foodstuffs became contaminated with
Caesium-137, Strontium-90 and uranium fuel particles containing a range
of novel radioactive elements.
Rather than use this opportunity to investigate the health effects of
these exposures, the international radiation risk community has ignored the
many reports of ill-health emerging from the contaminated territories.
International and National bodies (e.g. ICRP, UNSCEAR, BEIR, WHO)
whose remit is the evaluation of ionising radiation effects on health, have
glossed over, marginalized, ignored or denied the existence of the terrible
consequences of the Chernobyl fallout. Research papers have been excluded
from official reports. Cries for help have been dismissed as due to
‘Radiophobia’.
Research into these effects has been mainly published in Russian
Language journals; these valuable contributions have (perhaps purposely)
rarely been translated into English. To do so would have been fatal to the
nuclear industry which routinely discharges the same radioactive substances
to the environment under license.
This new ECRR publication presents the true consequences of the
Chernobyl accident. Eminent scientists examine and review the data and
show that rather than fading away, the effects are only beginning to show
themselves. The phenomenon of ‘genomic instability’, discovered in the
laboratory in the UK in the 1990s, is seen now in its terrible effects on the
animals, plants and human victims of the Chernobyl exposures. It is seen at
doses that would have been, and still are, dismissed as vanishingly small by
the current radiation protection laws.
Here are data from the real world: the world of the Chernobyl
laboratory. Policymakers, scientists and members of the public would do
well to absorb the truly terrifying implications of these data for the
consideration of both the health of the victims and for the development of
nuclear energy and radioactive waste disposal policies.
The Committee is anxious to make this volume widely available and has set
aside copies to be sold at the concession price for those individuals,
students, etc. who may be unable to afford the full price £55. This download
is free. For further information apply to: [email protected]
ISBN: 1-897761-25-2